adviser easy reference guide for individual...

Adviser Easy Reference Guide for Individual InsuranceIssue date July 2008

i

Welcome Section 1 – Underwriting – general2 Underwriting philosophy and

service charter

6 Height and weight guide

7 Guide to common medical conditions

15 Paramedical provider

15 Residency

16 Querying underwriting decisions

17 Conversions, continuation options and transfers

19 Takeover terms (transfers)

20 Reinstatement process and requirements

21 Reassessment of health or occupation

21 Reassessment of pursuits

21 Request to alter to non-smoker premium rates

21 Bankruptcy

22 Handy underwriting tips

27 Alteration requests – underwriting requirements

Section 2 – Underwriting – Life, Trauma and Total and Permanent Disability (TPD)30 Medical mandatory requirements

32 Financial mandatory requirements

33 Financial underwriting considerations – Personal and Business

40 Financial underwriting – Business Solutions Option

Section 3 – Underwriting – Income Insurance and Business Expenses43 General information

43 Third party ownership

44 Medical mandatory requirements

44 Financial mandatory requirements

45 Insurable income explained

45 Superannuation contributions

46 Indemnity insurance

46 Agreed value financial underwriting up-front

47 Unearned income

48 Income Splitting

48 Business Expenses Insurance

Section 4 – Product information51 Life

52 Trauma

53 Total and Permanent Disability (TPD)

53 Activities of Daily Living TPD

54 Income Insurance

56 Income Insurance information table

57 Business Expenses

58 Large case discounts

58 Adviser commission details

58 Changing plan ownership

Section 5 – Occupations – general63 Income Protection and TPD

considerations

Section 6 – Occupations – list67 Occupation rate categories

68 ‘Own’ occupation TPD listing

71 Occupation listing

Section 7 – Pursuits and pastimes92 Pursuit and pastimes listing

Section 8 – Claims information95 Claims philosophy

96 Notification of claims

97 Assessment of claims

104 Payment of claims

Section 9 – Index

Contents

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1

Welcome to your Adviser Easy Reference GuideThis reference guide provides you with information about how we manage our individual insurance business.

We understand that to best manage your client’s expectations, you need transparency in the guidelines we use. In this guide, you will find some useful tools to help you write individual business with us.

For information regarding our Group Life products, please refer to the Group Life Underwriting Guide. For Platform insurance and Super Directions products, please refer to the relevant administration areas.

We encourage you to call us about any underwriting or claims enquiries you may have. You can contact us at:

AXA Australia PO Box 14330 Melbourne VIC 8001 Telephone 1800 655 655 www.axaadvantage.com.au

Underwriting – generalAdviser Easy Reference Guide to Insurance

Important information

This publication has been prepared for distribution to professional financial advisers only and is intended to provide factual information. AXA Australia does not authorise the distribution of this publication to or use by existing or potential investors. Existing or potential investors should base their investment decision on the detailed information contained in the current Product Disclosure Statement (PDS) and should consult their financial adviser. Applications for the issue of AXA Australia products will only be accepted on receipt of an application form accompanying a current PDS. The National Mutual Life Association of Australasia Limited and its associates derive income from issuing interests in the products, full details of which are contained in the PDSs This information is provided for persons in Australia only and is not being provided for the use of any person who is in any other country.

2

Underwriting philosophyWe have a duty to you and your clients to thoroughly evaluate each Application we receive and to offer underwriting terms, based on a thoughtful and reasonable assessment of the evidence presented and having regard to the individual circumstances of the case.

We will keep you fully informed about the progress of your Applications and will provide you with a logical reason for any decisions we make. It will not always be possible to offer terms that are agreeable to every applicant who submits a proposal, but we will seek to offer alternatives whenever it is practicable and sensible to do so.

We are committed to providing an efficient and competitive underwriting service and will work with you to provide a solution to the insurance needs of your clients.

Underwriting Service CharterThis Underwriting Service Charter affirms our commitment to providing you and your clients with a professional, timely and transparent underwriting service.

Our team

We have a team of Underwriters committed to you and your clients.

Underwriters Our Underwriters are located across Australia and New Zealand. We share a sophisticated work allocation system designed to treat all applications in the most efficient way possible. In the vast majority of cases, your applications will be assessed in a region near you. We can also call on resources in other regions in times of high demand.

Senior Underwriters

Our most experienced Underwriters handle your large and complex cases. Their knowledge means that the right questions are asked at the right time, ensuring that high value cases are addressed professionally and efficiently.

Field Underwriters Our Underwriters are supported by Field Underwriters, who are able to partner with you to assist with complex or large cases. These cases may require highly technical underwriting involvement, and our Field Underwriters are on hand to help.

Chief Medical Officer and Senior Medical Officers

All our underwriting sites benefit from the experience of our resident Chief Medical Officer in the assessment of complex medical histories. Each underwriting site also has access to visiting Senior Medical Officers, who are specially trained in insurance medicine.


3

Our commitment to you

Communication We will keep you fully informed of the progress of your risk applications. This includes:

*Advise and explain any adverse decisions.

* Advise and explain any further underwriting requirements, if the reasons for the request are not clear.

* Advise any alternative offers if we are unable to offer the proposed cover.

* We offer these services by telephone where possible to minimise delays.

Progress and enquiries

Our online enquiry system, AXA Online, allows you to view the status of your applications, and lodge underwriting and claims enquiries, which are automatically directed to our work management system.

Our commitment to your client

The decision We will thoroughly review each application and provide the best decision possible, consistent with our risk management philosophy. Before declining any proposal we will explore alternative solutions through our Alternative Offer Forum. We will also seek the guidance of our Medical Consultants and Reinsurers where appropriate.

Alternative Offer Forum

The Alternative Offer Forum is a daily discussion group lead by our more Senior Underwriters. In the Forum, the Senior Underwriters discuss Individual Insurance cases that may be declined or offered with non standard terms with a view to considering alternative solutions.

Where appropriate, an adverse decision will be referred to our Alternative Offer Forum to discuss alternative terms that may be available. These alternatives could include offering loadings, exclusions, adjustments of the plan term (referred to as limited term plans), adjustment of benefit or waiting periods or even other types of cover.

Medical Information

We will advise your client’s doctor directly (where authorised) of the reasons behind our decisions. This avoids undue delays and worry for the client while waiting for explanation of decisions or test results. Should an issue relating to your client’s health come to light during the medical assessment of their application, we will ensure that the information is relayed to their doctor urgently (where authorised).

4

Contact us

Contact Centre Our Contact Centre is staffed with fully qualified consultants ready to assist you with your query. Please ensure that you have your adviser number ready.

1800 655 655

AXA Online Go to AXA Online for a view on the status of your applications and to submit underwriting and claims enquiries on specific proposal and policy numbers.

www.axaonline.com.au

Underwriting For Underwriting queries, please contact the Underwriter assigned to your client. This information can be located through AXA Online. For pre-lodgement enquiries, please telephone our Contact Centre. To submit underwriting evidence please fax documentation where possible to expedite the process.

www.axaonline.com.au

1800 674 684 (fax)

Underwriting Forms

For underwriting related forms, please refer to website for downloads.

www.axaadvantage.com.au

Field Underwriting Should you need assistance with large and complex cases, a Field Underwriter can assist you.

Contact your Business Development Manager


Our commitment to your client (continued)

Financial Information

We will contact your client’s accountant directly (where authorised) to expedite the financial underwriting process.

Telephone Underwriting

We will contact your client directly (if an authority is provided), to obtain the answers to missing questions, and to seek clarification of information provided, in order to expedite the processing of the application.

5

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6

Height and Weight Guide

Overweight

Research has shown that being overweight is associated with being at an increased risk of a number of diseases such as heart attack, stroke, diabetes and hypertension.

The Body Mass Index (BMI) has become widely accepted as a way to measure body weight in comparison to height. The BMI is easy to calculate and can be applied regardless of gender. A BMI within the range of 20 to 25 is considered healthy while greater than 25 is considered overweight. A BMI greater than 30 is considered obese and a premium loading may apply depending on the benefit type, the terms and conditions applied for and the presence of any other risk factors. Other risk factors may include high blood pressure, raised cholesterol or family history of heart disease. BMI is calculated by dividing the body weight in kilograms by the square of the height in metres (kg/m2).

For example:

Weight 90kg and Height 180cm BMI = Weight / Height x Height BMI = 90 / (1.8x1.8) = 28 BMI

We are now using the BMI as a simple way to indicate to you when a mandatory medical examination or mini check examination may be required. Our general approach is described below:

All Products – All Ages

BMI range Requirements

BMI up to 32 Personal statement

BMI between 33 and 39* Personal statement and Mini Check Examination**

BMI 40+ Personal statement, full Medical Examination/Paramedical and MBA20

* An MBA20 will be requested where the BMI is 35 or above

** Mini Check Examination: an abridged version of the medical examination that can be performed by a registered nurse

Please note that the Underwriter may call for a medical examination at a lesser BMI at their discretion, taking into account all risk factors that may be present. In some instances the Underwriter may be able to offer your client a choice of assessments. For example, a longer waiting period for Income Insurance may mean that a premium loading may not be necessary or can be reduced.


7

Underweight

Being underweight may be associated with, or a sign of a number of diseases including cancer, bowel disease or an eating disorder.

A BMI of less than 20 is considered underweight. A medical examination may be required when the BMI is 18 or less. Please contact an Underwriter to discuss.

Guide to common medical conditions

Legend

Medical evidence

PS Personal Statement ECG Electrocardiogram PMAR Private Medical Attendant’s Report ME Medical Examination Mini Check An abridged version of the Medical Examination that can be performed Examination by a registered nurse Q’re Questionnaire or full details on personal statement if no specific questionnaire available Q’re/PMAR Questionnaire first then possibly a PMAR MBA20 Multiple Biochemical Analysis blood test Lipid Profile Cholesterol and triglyceride blood test

Assessments

Std Standard rates will usually apply (that is, standard mortality or morbidity) +50* 50% extra mortality/morbidity +75* 75% extra mortality/morbidity +100* 100% extra mortality/morbidity +150* 150% extra mortality/morbidity# +200* 200% extra mortality# +250* 250% extra mortality# +300* 300% extra mortality# +350* 350% extra mortality# +400* 400% extra mortality# +450* 450% extra mortality# +500* 500% extra mortality# E Cover may be offered with an exclusion clause PP Cover not available at this time D Cover will be declined IC Individual Consideration

* An extra premium loading will apply

# Inbuilt Convertibility and CPI are not available

8

This section following provides you with a guide to more common medical conditions. It is intended as a guide only and individual circumstances will vary.

Please note the assessments indicated are a guideline only. Underwriters also take into account what are known as ‘credit’ and ‘debit’ factors in the person’s risk profile. Alternative assessments may be offered (for example limited terms, exclusions, loadings, longer waiting periods and shorter benefit periods) or cover may be declined depending on the presence of these other factors. Limited plan terms may be offered as alternatives on Life, TPD or Trauma insurance. At this time limited plan terms are not available for Income Protection.

Condition type LifeTrauma & ADL TPD TPD

IP (30 day WP)

Medical evidence

Alcohol dependence normal liver tests, no neurological or mental disorder. Total abstinence for 0 – 3 years

200-PP

PP PP D PMAR and MBA

Alcohol dependence normal liver tests, no neurological or mental disorder. Total abstinence for 4 – 6 years

50-100

50-100 IC D PMAR and MBA

Anxiety (well treated or fully recovered)

Std-D Std-D IC IC Q’re/PMAR

Arthritis – osteoarthritis Std Std E-D E-D PMAR

Arthritis – psoriatic 50-100

50-D E-D E-D PMAR

Arthritis – rheumatoid 50-100

50-D E-D E-D PMAR

Asthma mild Std Std Std Std-50 Q’re

Asthma moderate 50 50 50-100

50-100 PMAR

Asthma severe 100-D 50-D D D PMAR

Back Disorders – Disc Prolapse Std Std E E Q’re/PMAR

Back Disorders – Laminectomy Std Std E E Q’re/PMAR

Back Disorders – Scheuermann’s Std Std E E Q’re/PMAR

Back Disorders – Severe Scoliosis Std Std E E Q’re/PMAR

Back Disorders – Spinal Fusion Std Std E E Q’re/PMAR

Back Disorders – Spinal Stenosis Std Std E E Q’re/PMAR

Back Disorders – Spondylolisthesis Std Std E E Q’re/PMAR

Back Disorders – Spondylosis Std Std E E Q’re/PMAR


9


IP (30 day WP)

Medical evidence

Back Disorders – All other back complaints

Std Std IC IC Q’re/PMAR or multiple risk factors

Blindness – Unilateral Std E E E PS

Blindness – Bilateral Std E E-D IC PS/PMAR

Blood Pressure – Refer to Cardiovascular Disease

Bronchitis – Acute complete recovery

Std Std Std Std Q’re

Bronchitis – Chronic (rating range depends on severity and smoker status)

50-D 50-D 50-D D PMAR

Cancer – all types (after recovery) IC IC IC IC PMAR

Cardiovascular Disease – Angina 50-D D D D PMAR, ME, ECG

Cardiovascular Disease – Heart Attack or Bypass surgery (depends on type, the degree, duration since episode, age and other risk factors)

IC D D D PMAR, ECG, ME

Cardiovascular Disease – Heart Valve Surgery

50-D D D D PMAR, ME

Cardiovascular Disease – High blood pressure, well controlled on treatment for > 3 months (no other risk factors)

Std IC Std Std PMAR

Cardiovascular Disease – High blood pressure, not well controlled, no treatment, or treatment started within 3 months

50-PP PP PP PP PMAR

Cardiovascular Disease – Stroke (will depend on severity and duration since stroke, type, age, recovery)

Std-D D D D PMAR

Cholesterol on medication with a normal reading

Std IC Std Std PMAR, may require MBA with lipid profile

10


IP (30 day WP)

Medical evidence

Cholesterol – Abnormal reading IC IC IC IC PMAR, may require MBA with lipid profile

Coeliac Disease – Well controlled with diet or medication, no symptoms or complications

Std-100

Std-100 Std-100

50-D PMAR

Coeliac Disease – With symptoms, not well controlled

100 D D D PMAR or ME

Crohn’s Disease (Rating will depend on complications, number of episodes, treatment and time elapsed since last episode)

50-250

50-D E-D E-D PMAR or ME

Deafness – Progressive (cause known)

IC IC IC IC PMAR

Deafness – Unilateral (cause known) Std E Std-E E PMAR

Deafness – Bilateral (cause known) Std-50 E E E PMAR

Depression (well treated or fully recovered)

Std-D Std-D IC IC Q’re/PMAR

Dermatitis/Eczema (See Skin Disorders)

Diabetes Type I (Insulin Dependent) 50-D E-D 75-D D PMAR or ME, and results of most recent blood tests

Diabetes Type II (Non-Insulin Dependent)

50-D E-D 75-D D PMAR or ME, and results of most recent blood tests

Drug Abuse – current D D D D Nil

Drug Abuse – within 3 years last use PP D D D Nil

Drug Abuse – Total abstinence 3 – 5 years

IC D D D Q’re, PMAR

Drug Abuse – Total abstinence > 5 years

IC IC IC IC Q’re, PMAR

Emphysema – Mild 50-100

100-D 100-D D PMAR or ME

Emphysema – Moderate to Severe 100-D D D D PMAR or ME


11


IP (30 day WP)

Medical evidence

Endometriosis – full recovery Std Std-E Std-E Std-E Nil

Endometriosis – Under treatment Std-50 Std-50 50-E 50-E PMAR

Epilepsy – within 1 year of diagnosis PP PP PP PP Nil

Epilepsy – > 1 year since diagnosis, depending on number of attacks

Std-PP Std-D 50-D 50-D/E Q’re, PMAR

Gall Stones – removed, full recovery Std Std Std Std PS, may require PMAR if recent

Gall Stones – present 50-100

Std-50 E E PMAR

Gout – depending on uric acid levels and presence of arthritis

Std-150

Std-100 Std-E Std-E Q’re, PMAR

Haemochromatosis – under medical supervision

Std-D IC IC IC PMAR

Haemorrhoids Std Std Std-E Std-E PS/PMAR

Hay Fever Std Std Std Std Q’re/PMAR

Hepatitis A – full recovery, > 6 months

Std Std Std Std Q’re/PMAR

Hepatitis B – full recovery, > 6 months

Std Std-PP Std-50 Std-PP PMAR, MBA, Hepatitis serology

Hepatitis B – carrier 50-D 75-D 50-D 50-D PMAR, MBA, Hepatitis serology

Hepatitis C 50-D 50-D IC IC PMAR, MBA, Hepatitis serology

Hernia – 3 months post operation or no operation planned

Std-50 Std-50 Std-E Std-E Q’re

Hysterectomy – for benign disease, full recovery

Std Std Std Std Q’re/PMAR

Indigestion Std-50 Std-50 Std-50 Std-100

Q’re/PMAR

Iritis – no underlying disease, full recovery, no residual visual impairment

Std Std Std Std PS, PMAR

Iritis – present, no underlying disease Std E E-PP E-PP PS, PMAR

12


IP (30 day WP)

Medical evidence

Irritable Bowel Syndrome – Mild, fully investigated (this rating excludes any additional rating for any underlying cause)

Std Std Std 0-50 PS/PMAR

Irritable Bowel Syndrome Moderate, fully investigated (this rating excludes any additional rating for any underlying cause)

Std Std Std 50-100 PMAR

Irritable Bowel Syndrome, not investigated

IC IC IC IC PMAR

Kidney Stones – History of, no kidney damage, blood pressure and urine normal

Std-50 Std-50 Std-50 Std-E PMAR or ME

Kidney Stones – Present, recurrent or with symptoms/kidney damage

IC IC-D PP PP PMAR or ME

Knee disorders – Cartilage, ligament, recurrent pain, unstable joint, reconstruction, or other surgery. No manual work

Std Std IC IC Q’re

Knee disorders – Cartilage, ligament, recurrent pain, unstable joint, reconstruction, or other surgery. Manual work

Std Std E E Q’re

Lupus – Discoid Lupus (SLE excluded)

Std-50 Std-50 PP-E PP-E PMAR

Lupus – Systemic Lupus Erythematous (SLE)

PP-100

IC IC IC PMAR

Leukaemia – Acute or chronic (Fully recovered)

IC IC IC IC PMAR

Malignant Melanoma – All types, adequate follow up. Rating will depend on staging of tumour

IC IC IC IC Q’re/PMAR or pathology results

Meniere’s Disease – Tumour and cardiovascular disorder ruled out

Std Std E-D E-D PMAR

Multiple Sclerosis, Mild to Severe 50-D D D D PMAR

Paralysis as a result of trauma IC IC D D PMAR

Parkinson’s Disease, Mild to Severe (ages >40 only)

50-D D D D PMAR


13


IP (30 day WP)

Medical evidence

Pleurisy (Dry Pleurisy) – fully recovered

Std Std Std Std PS/PMAR

Pleurisy (Exudative Pleurisy) – fully recovered

Std-50 Std-50 50-PP IC PMAR

Pneumonia – History of, full recovery Std Std Std Std PS/PMAR

Prostatitis – Acute, Mild to Moderate Std Std-50 Std-50 Std-E PMAR

Prostatitis – Chronic 50 50-100 E E PMAR

Psoriasis – No arthritis, Mild Std Std Std Std Q’re

Psoriasis – No arthritis, Moderate to Severe

Std Std E E Q’re/PMAR

Psoriasis – Psoriatic Arthritis 50-100 50-D E-D E-D Q’re, PMAR

Pterygium – Present Std E E E PS

Pterygium – History of Std Std Std Std PS

Ross River Virus – Present PP PP PP PP PS

Ross River Virus – History of, full recovery, no complications, > 6 months since last symptoms

Std Std IC IC PMAR

Sleep Apnoea – Sleep Study performed

Std-D Std-D 50-D 50-D PMAR

Skin Disorders Eczema/Dermatitis, See also Psoriasis

Std Std Std-E Std-E Q’re

Tendinitis Present Std Std E E Q’re

Tendinitis – History of, no time off work, 12 months symptom free, no manual work

Std Std Std Std-E Q’re

Thyroid Disorder – Hyperthyroid (Graves Disease) – Present, Mild

Std-50 50 PP PP PMAR

Thyroid Disorder – Hyperthyroid (Graves Disease) – Moderate – Severe

100-D D D D PMAR

Thyroid Disorder – Hyperthyroid (Graves Disease) – History of, well controlled on treatment for > 6 months

Std-50 Std-50 Std-50 Std-50 PMAR

Thyroid Disorder – Hyperthyroid (Graves Disease) – History of, surgical treatment > 12 months ago

Std Std Std Std PMAR

14


IP (30 day WP)

Medical evidence

Thyroid disorder – Hyperthyroid – Congenital

50-100

50-100 IC IC PMAR

Thyroid disorder – Hyperthyroid – Acquired, with successful treatment


Thyroid disorder – Hypothyroid – Untreated

P P P P PMAR

Thyroid disorder – Hypothyroid – Successful treatment, no

symptoms, no complications


Thyroid disorder – Hypothyroid – Other cases

+100 to D

D D D PMAR

Tinnitus – Present Std-50 IC E-D E-D PS/PMAR

Tinnitus – History of, > 6 months symptom free, no underlying cause

Std Std Std Std PS/PMAR

Ulcer (Peptic) – History of, fully recovered

Std-50 Std-50 Std-50 Std-E Q’re/PMAR

Ulcer (Peptic) – Present, Mild Std-50 Std Std-50 E Q’re, PMAR

Ulcer (Peptic) – Present, Moderate/Severe

Std-50 IC E D Q’re, PMAR

Ulcer (Peptic) – Present, Chronic 50-100 IC D D Q’re, PMAR

Ulcerative Colitis – Medically treated, Mild

Std-100

50-100 E IC PMAR or ME

Ulcerative Colitis – Medically treated, Moderate

50-150

100-D E-D IC PMAR or ME

Ulcerative Colitis – Medically treated, Severe

50-D 100-D D D PMAR or ME

Ulcerative Colitis – Surgically treated < 6 months

PP PP D D PMAR

Ulcerative Colitis – Surgically treated > 6 months

Std-50 50-100 D D PMAR or ME

Ulcerative Colitis – Surgically treated > 5 years

Std Std E E PMAR or ME

Varicose Veins – Legs Std Std Std Std-E PMAR

Varicose Veins – Haemorrhoids Std Std Std Std-E PMAR


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Paramedical providerWe have available a mobile pathology/paramedical provider, Unified Healthcare Group (UHG), to assist with the provision of medical requirements.

In most cases your client can have a required medical examination and any blood samples taken at a time and place convenient for them. The pathology/paramedical provider will look after the appointment and medical requirements for you.

In some instances a client will reside in an area not serviced by the pathology/paramedical provider. On these occasions the client will need to be examined by a general practitioner. In these circumstances UHG will arrange the general practitioner examination.

You may wish to make alternative arrangements yourself for medical examinations and tests. Please ensure our Administration area is notified by noting this clearly in the Application Form under the Adviser and Commission details. This ensures that we do not inconvenience your client by duplicating arrangements and requirements.

Unified Healthcare Group UHG (preferred provider)

Phone: 1800 101 984 Fax: 1800 707 697 Website: www.uhg.com.au/lifetrack

Online tracking of all your client’s medical requirements arranged through UHG is available using the above website.

Should you require an alternative provider please contact Pathrec on 1800 066 895.

Residency

Availability of cover

Generally, only Applicants with permanent Australian residency status may be considered for insurance cover. Non-residents who return to their own countries are subject to different insurance legislation and disputes forums.

Terms for Life, Trauma and TPD may be considered for temporary residents seeking permanent residence in Australia, subject to underwriting approval prior to lodgement of the Application. Details will be required including:

full details of the type and nature of visa (please provide a copy)•copy of the letter from the Immigration Department with details of and status of •permanent residence application

any other information that could be helpful including details of any assets held in •Australia or other family members who are permanent residents etc.

Terms for income insurance may be considered for some temporary residents on working visas. Conditions apply, please contact your business development representative for further details.

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Australian residents working or travelling overseas

Cover for Australian residents who are travelling or working overseas will need to be approved by the Underwriter, and will be considered on an individual basis. In some instances cover will not be available and will be declined until return to Australia, or an extra premium or exclusion may apply to cover any extra risk such as political unrest.

Australian residents who intend to work or travel overseas for extended periods of time are usually not eligible for Trauma, TPD or Income Protection.

Generally we are guided by the advice of our Reinsurers and the Department of Foreign Affairs and Trade (www.dfat.gov.au) in considering these applications.

The DFAT website has been updated and now includes five levels of advice which are allocated to any areas around the world that may be of concern to individuals when travelling. They are:

1 Be alert to your own security

2 Exercise caution

3 High degree of caution

4 Reconsider your need to travel

5 Do not travel

Applications will be declined for clients travelling to areas covered by Level 4 or 5 advices. Exclusions will apply to clients travelling to areas covered by a Level 3 advice. Country specific exclusions are available for short term travel subject to confirmation that insurance will not be cancelled on return.

Querying underwriting decisionsPlease refer all queries regarding underwriting decisions to the Underwriter who made the decision. They will be able to explain the assessment to you to assist you in your discussions with your client.

There may be circumstances where you understand and agree with the assessment however feel an adverse underwriting decision may have a detrimental effect on AXA. For example, any future business this client may generate (additional cover, investments and superannuation schemes etc.) could be dependent on the acceptance of the risk business.

In these instances, we ask that you submit in writing an explanation as to why an alternative assessment should be considered.

The following criteria will be used when assessing a business case:

the value of your current or future related business;•current value of the client, including business contained within other product lines or •AXA companies; and

the future potential of this client.•


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The business case should be referred to the Underwriting Manager for consideration. Business decisions of this nature will be discussed with the Product Manager.

Conversions, transfers and continuation options

Conversion and transfer of individual insurance cover

AXA and AC&L Individual Life, Trauma and TPD may be converted to an AXA Individual Insurance plan subject to certain requirements (listed below).

Plans that can be converted include AXA Individual Insurance, AC&L Individual Insurance, Flexipol, Provider, Goldline, FSP, RSP and Conventional Plans (such as Whole of Life and Endowment). The requirements include:

Any loadings, restrictions or exclusions on the existing cover will apply to the •new plan

If the existing plan has been loaded greater than 100%, conversions are not allowed •unless the existing plan has inbuilt convertibility which has not been deleted

An increase in the term of cover is only allowed for stepped plans•If the current plan is reinsured then automatic conversion may not be available. •Further information may be required and will be determined by the Underwriter once the application form has been received and may involve a request for medical and financial information. Permission will also need to be obtained from the reinsurer.

The life insured must be the same on both plans•New business commission is only payable on any increase in premium•The commission structure of the converted plan must be the same as the plan that it •is replacing

Any increase to the sum insured will require underwriting•Income Protection and Business Expenses Protection cannot be converted•Age rules and other conditions apply.•

All conversions are subject to the following underwriting requirements:

Application summary of the current application form•Signed and dated Declaration & Consent section.•

Conversions or transfers into Platform Insurance

A conversion into Summit or Generations is not automatically available. A transfer declaration is required in the first instance in all situations.

Please talk to your BDM regarding your specific case.

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Conversions or transfers from Business Super

Transfer of insurance cover to an AXA Individual Insurance Plan may be available to a member from Super Directions for Business, Simple Super (SS), Tailored Super (TS) subject to the following requirements:

Full underwriting will be required if the existing sum insured was not underwritten or •for any increase in the sum insured

Any loadings, restrictions or exclusions on the existing cover will apply to the •new plan

If the existing plan has been loaded 100% or greater, a conversion exclusion will be •applied to the new plan

The life insured must be the same on both plans•New business commission is only payable on any increase in premium•Limitations may apply to reinsured business. Permission will have to be obtained from •the relevant reinsurer

Temporary but Total Disablement (TTD) cover cannot be converted•Age rules and other conditions apply.•

All transfers are subject to the following underwriting requirements:

Application summary of the current application form•Residence and travel details•Insurance details•Smoking question•Sports and pastimes details•Occupation details (TPD and Salary Continuance)•Income details • (TPD and Salary Continuance)

Signed and dated Declaration & Consent section.•

Inbuilt Convertibility and CPI

Inbuilt convertibility and CPI are not available for cover exceeding 100% extra mortality.

Continuation options

A Continuation option may be available when a member leaves an AXA group plan such as their employer’s Group insurance plan, Summit or Business Superannuation fund. The member may wish to continue their insurance cover through an AXA Individual Insurance Plan.

Provided a Continuation Option is available from the plan and the requirements applicable to the benefits are met, the continuation of cover to AXA Individual Insurance Plan will be available without the need for additional medical evidence. We must be in receipt of a Continuation Option form signed by the member


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All continuation options are subject to the following underwriting requirements:

Application summary of the current application form•Residence and travel details•Insurance details•Smoking question•Sports and pastimes details•Signed and dated Declaration & Consent section•

In addition, if the Continuation Option is for Salary Continuance or TPD the following is also required:

in the first instance the full completion of the occupation and income sections of the •personal statement will be required and is subject to underwriting

The Continuation Option expiry date will be 60 days (depending on the conditions of the plan) after ceasing employment with the employer who is the owner of (or party to) the Group Insurance plan. No extensions to this date will be available. Continuation Options are not available upon the closure of a plan.

Takeover terms (from another insurer)We may accept individual risk insurance that has been underwritten by any other insurance company provided the conditions below are met. Transfers are only allowed for Life, Trauma and TPD Insurance. Transfer terms are not available for Income Protection or Business Expenses.

Takeover criteria

The plan being transferred must satisfy the following criteria before a transfer can take place:

the maximum transfer age for the person to be insured is 60 years;•the transferring plan must be in force;•the transferring plan must have been fully underwritten within the last 5 years;•the transferring plan must have been accepted at standard rates;•the transferring plan must transfer to a similar type of contract, for example Stand •Alone Trauma may not be automatically transferred to a plan containing Life cover;

any existing exclusions on the transferring plan will apply to the new plan;•for Life cover the maximum sum insured cannot exceed $3 million;•for Trauma cover the maximum sum insured cannot exceed $1 million;•for TPD cover the maximum sum insured cannot exceed $2 million; and•the 13 month suicide clause on Life cover and the 90 day waiting period on Trauma •cover will be waived as long as the transferring plan and equivalent benefits have been in force for this period of time.

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Takeover requirements

If the Takeover criteria are fully satisfied, the following evidence is required:

Life and TPD cover only up to $2 million

fully completed Takeover of Life and TPD Cover up to $2 million only form (containing •short form personal statement);

the original policy schedule; and•the most recent renewal notice.•

All other requests

fully completed application form (and full personal statement);•the original policy schedule; and•the most recent renewal notice.•

Mandatory medical and financial evidence will be waived, however full discretionary underwriting still applies. The Underwriter may still request medical or financial evidence on a discretionary basis.

The original policy schedule and latest renewal notice are required to provide evidence of:

the transferring policy being currently in force and premiums paid;•the benefit amount and type (including CPI increases);•acceptance at standard rates and details of any exclusions or restrictions; and•confirmation that the policy is not being transferred to another insurer.•

If these pieces of evidence are not available we may be able to accept alternative evidence, provided the above information is adequately disclosed to the satisfaction of the Underwriter.

Reinstatement process and requirementsThere are some circumstances in which a plan may lapse. Reasons this may occur include:

an inability to pay premiums;•alteration of bank account details that have not been advised to us;•renewal notices not being actioned; or•a change of address has not been advised to us.•

Provided six months has not passed since the plan ‘date paid to’ the plan may be reinstated as per the table on the next page.

Plans that have been cancelled on request of the policy owners cannot be reinstated. Full underwriting will be required to establish a new plan.


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The evidence required to reinstate a plan is as follows:

Date paid to Evidence required

60 days or less since the ‘date paid to’

Nil. If your client pays full arrears within 60 days plan will be automatically reinstated

61 days – 6 months Application for reinstatement*, including income details•Any discretionary evidence requested by the Underwriter •HIV/MBA2O/Hep B&C blood tests (only if over current limits •and last test was more than 12 months ago)Payment of any premiums requested•

Over 6 months since the ‘date paid to’

Cannot be reinstated. A new plan is required with full underwriting

* An application for reinstatement form can be found at www.axaadvantage.com.au

Reassessment of health or occupationIf the client requests reassessment of a health loading, a health exclusion or occupation category rating on an existing policy, we will initially request a Personal Statement. A short form Personal Statement and questionnaire may be the only requirements for reassessment of a health exclusion. Please contact underwriting for details.

All aspects of the client’s health, occupation, pastimes and residence will be reviewed. Further health evidence may be required.

Reassessment of pursuitsIf a client requests reassessment of a pursuits exclusion or loading (for example, a diving exclusion) on an existing plan, we will initially request a pursuits questionnaire. Further evidence may be requested based on the questionnaire.

Request to alter to non-smoker premium ratesIf a client requests an alteration from smoker to non-smoker rates, we will initially request a smoking questionnaire. The client must have ceased smoking for at least 12 months to be considered and must not have ceased smoking for medical reasons.

Any premium alteration will be made at our discretion. We will not backdate any premiums prior to the date the change is approved.

BankruptcyThe Federal Court usually declares bankruptcy if an individual’s liabilities exceed their assets and/or accounts cannot be paid.

There can be many different reasons for someone to have been declared ‘Bankrupt’:

guarantor on a loan for a third party which was not repaid;•

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small business unable to pay their bills;•silent partner in an investment/business which fails; or•major investment error, poor management of company funds.•

Life and Trauma Cover

When there is a current or past history of bankruptcy, life and trauma benefits for family protection will be assessed on their merits. Consideration will be given to any health problems that could be aggravated by financial crisis, including circulatory disorders, anxiety and depression.

Income Protection and Total and Permanent Disability Cover

We do not offer Income Protection or Total and Permanent Disability cover if a client is currently bankrupt and has not been discharged. If there has been a history of bankruptcy, further evidence will be requested and cover may not be available.

Requirements

The circumstances vary significantly from case to case so it is difficult to take a direct approach. However, it is important we obtain the right information to enable the best assessment of the situation. In most cases the client will be requested to provide a statement which should include the following:

reason and full details of ‘bankruptcy’ including amounts of money involved;•if criminal proceedings have followed and are pending (in these cases generally no •cover will be offered);

whether the client still has financial commitments to the other parties involved and if •so, how much? Will it impact current business or lifestyle?

proof of income for last 5 years including employment history; and•a Private Medical Attendant’s Report from the usual doctor will usually be requested •by the Underwriter.

Handy underwriting tipsIf you have any queries about a client you are advising in relation to insurance, call an Underwriter. The Underwriter can provide the right advice up front. Here are some handy tips to guide you through the underwriting process.

A brief client background

The Underwriter does not know the client. The only information we have about your client is what they supply in the Personal Statement. A note from you briefly outlining the client’s background is often invaluable and can minimise the number of phone calls and requests for additional information. A note providing extra background details may make all the difference. Please use the ‘Adviser notes’ section at the back of the Personal Statement.


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Adviser checklist for correct completion of the application and Personal Statement

Application summary

Have you shown occupation and industry in which applicant works?•Have you shown insurable income for last 12 months?•If applying for an alteration or increase to an existing plan, please make sure you •clearly state what the existing benefits are and what the new benefits being proposed are. It is also helpful to summarise the changing situation in the adviser notes.

Have you shown all benefits required on this page? In particular the type of plan, •occupation class, and when applying for income protection and/or business expenses, the monthly benefit, waiting period and benefit period.

Residence

If applicant is not an Australian resident have you included information as to what •visa is held, country of residency, date of arrival in Australia and date of intended departure from Australia?

If applicant intends travelling overseas have you supplied details of destinations also •reason for and dates of intended travel?

Other insurance

If there is other current insurance involved have you shown the sum insured and •indicated whether that cover is to be replaced or not?

If applicant has been accepted at other than standard rates or been declined in the •past have you included details of that assessment including the company involved and the date of the assessment?

If there are concurrent Applications being submitted for this life, have all details been •cross referenced on all Application Forms?

Health details

When completing the details of the applicant’s current doctor, have you included the •date, reason and result of last consultation?

If applicant has answered yes to having received advice to reduce alcohol or tobacco •intake have you supplied details of the doctor involved and date advice was received?

If any questions relating to any joint disorders, asthma, back or neck disorders, •depression, anxiety or nervous conditions, cyst/mole/skin lesions, blood pressure or cholesterol have been answered ‘yes’, have you completed the appropriate questionnaire?

If the applicant has answered ‘yes’ to any of the medical questions, please ensure that •full details of dates, the condition, results of all investigations and who was consulted are provided.

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Sports and Pastimes

If applicant is involved in any sports and pastimes, have you completed the •appropriate questionnaire where applicable?

Questionnaires

If a questionnaire is required to be completed in regard to either health or pursuits or •pastimes have you had all questions answered and any additional information that may clarify the risk included in the adviser notes?

If more that one questionnaire is required (eg for several joint related issues), •additional forms can be downloaded from our website at www.axaadvantage.com.au.

Occupation and income details

Have you completed the full occupation history, not just the current occupation details?•Have full occupational duties been specified?•For employees, have you completed the income details for the last 2 financial years as •well as the current income details?

In the case of self employed applicants, have you completed the income details for •the last 2 financial years?

Business Expenses

If the applicant is applying for business expense cover have you fully completed •the questionnaire?

Authorities and Declarations

Have you had medical authorities signed and dated?•Where applicable have you had the financial authority signed and dated?•Has the applicant provided the name and contact details of their accountant, •if applicable?

Has the applicant authorised us to forward medical information to their usual •general practitioner?

Has the applicant provided the name of their usual general practitioner?•Have you had the declaration and consent both signed and dated?•

Adviser, commission details and notes

Have you indicated what the intention is in regard to existing business?•Have you indicated if you have or are having mandatory medical examinations or •pathology tests arranged?

Have you attached any additional information (such as financial evidence) that you •wish to submit with this application?

Have you used the adviser notes section to provide any additional information or •explain any unusual aspects of the risk?


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Have you made reference to any conversations you may have had with the office •prior to submitting business including name of person you spoke to and date of conversation?

Applications completed in full

A quick check that the Application has been fully completed before submitting it can help save time during the underwriting process.

Please check that:

all questions have been answered (refer to section below regarding the personal •statement on the medical examination form);

alterations are signed by your client – signatures to alterations are critical, as the •Underwriter must make sure the disclosure is legally compliant before finalising the Application. The Application and all the supporting documentation are the basis of the contract, so the normal legal contractual requirements exist.

Medical examination personal statement

The personal statement section of the current AXA medical examination form will not be required when the following criteria have been met:

full medical examination completed by a fully qualified doctor; •a copy of the fully completed application form personal statement is presented with •the medical examination form to the doctor prior to examination; and

signed declaration by the doctor, that the application form personal statement has •been sighted

This concession does not apply if a Mini Check examination is performed.

Telephone underwriting

Telephone underwriting is a great way to save time when we need to obtain additional information from your client. When you provide your client’s telephone numbers in the Personal Statement, we can contact your client directly to obtain the additional information (for example, clarification of a medical condition). This can sometimes remove the need for other more complex and time consuming requirements such as doctor’s reports.

Obviously if your client does not wish us to call them, we will respect this and follow the normal ‘paper’ process.

Type of insurance and information required

When completing the Application, keep in mind the type of insurance you are recommending to the client and pass on as much information as possible to the Underwriter. For example, if your client is applying for Income Protection, we are covering the client for their income and their occupation, therefore we need as much detail as possible regarding their occupation, employment history (and prospects if appropriate) and income.

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Attaching additional information

If you find there is insufficient space when completing any section(s) of the Application form, you can attach a page(s) containing further information to the Application. Where multiple pages are attached please ensure that the client signs and dates each page.

If your client has any additional information relevant to their Application, please include it with the Application. This information may include copies of medical records, flying or diving logbooks, financial records and tax returns. Remember, if a client can substantiate their disclosure at underwriting stage, it minimises calls for additional underwriting requirements and makes the claims process easier. For example, in some instances a copy of the following can be accepted instead of a discretionary Personal Medical Attendant’s report:

an x-ray report;•blood test; •specialist doctor letter; or•pathology report.•

Questionnaires

The Personal Statement includes some questionnaires that we ask your client to complete at the point of sale where appropriate. Fully completing these at the point of sale will save time during the underwriting process.

Further requirements

It is always best to follow up any requirements immediately and not wait until a ‘final reminder’ is issued. If you need to query anything, call the Underwriter of the application immediately, they will be happy to help.

Occupations

If you are unsure of the occupation rating for your client and are unable to contact an Underwriter, some advisers have suggested you rate your client more conservatively. Then you may be able to return to your client with a lesser premium.

New business administration requirementsDirect debit or credit card authority is to be completed where required.•Your adviser number is also required.•The first premium is to be enclosed with the application for direct methods or debit/•credit card authority for direct debit methods.Multiple applications are to be lodged together.• Ensure that the Insurance quote from the PQT is completed and enclosed with •the application.


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Alteration requests – underwriting requirements

Alteration requested Initial requirementsUnderwriting required?

Smoker to Non-Smoker Application for Smoker to Non-Smoker Yes

Review of Health Loading Application details and Personal Statement Yes

Review of Pursuits Exclusion Relevant questionnaire Yes

Review of Health Exclusion Review of health exclusion form Yes

Review of Occupation Category

Application details and Personal Statement Yes

Waiting Period Increase Letter from client No

Waiting Period Decrease Application details and Personal Statement Yes

Sum Insured Increase Application details and Personal Statement Yes

Sum Insured Decrease Letter from client No

Increase in Benefit Period Application details and Personal Statement Yes

Decrease in Benefit Period Letter from client No

Exercising Buy Back Option Application details No

Exercising Trauma Reinstatement Option

Application details No

Addition of Children’s Trauma Option

Children’s Trauma Personal Statement Yes

From Indemnity Option to Agreed Value (applies to plans from August 2005 to current series only)

Application details, Occupation and Income details section, residence, pursuits, other insurance, relevant financial evidence and declarations

Yes

Exercising the Business Solutions Option

Application details, relevant financials, details of occupation, residence, other insurance, and pursuits

Yes

Conversion to Senior Professionals Plan

Application details, Occupation and Income sections of the Personal Statement

Yes

Increase through Future Insurability (inc YN option)

Please refer to client’s plan document as requirements vary depending on product series

No

Addition of any Option Application details and Personal Statement Yes

Take up of Benefit Booster Option

Benefit Booster Application Yes

Cover Boost Option Application details, income section of the Personal Statement

Yes

Adding Indemnity Option Application details No

Out of Working Hours cover to 24 Hour cover

Letter from client No

Change of plan ownership Refer to page 58 —

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Underwriting – Life, Trauma and Total and Permanent Disability (TPD)Adviser Easy Reference Guide to Insurance

Medical limits – mandatory requirements

Definition of requirements

Medical examination

The medical examination is to be performed by the usual general practitioner

Mini Check Examination

An abridged version of the Medical Examination that can be performed by a registered nurse

Paramedical examination

The medical examination can be performed by a registered nurse

Specialist medical examination

The medical examination is to be performed by a Specialist Physician such as a Cardiologist (not a General Practitioner). Where a specialist medical examination is required, a medical examination by the usual doctor will not be required

Blood screen

HIV MBA20 Hep B & C

HIV blood test, Fasting MBA20, Hepatitis B & C serology

HIV (AIDS) Antibody Test Fasting Multiple Biochemical Analysis Hepatitis B Surface Antigen (HbsAg) and Hepatitis C Antibody (anti-HCV) tests

Resting ECG Resting ECG with interpretation

Exercise ECG Exercise/Stress ECG – incorporates a Resting ECG

PMAR Personal Medical Attendant’s Report

PSA Prostate Specific Antigen (Males only)

Cotinine Detects nicotine (may be a blood or urine test)

FBC Full Blood Count/Analysis/Examination

MSU Microscopic Urinalysis

For Medical Requirements for Life and TPD cover please refer to Table A. For Trauma cover please refer to Table B.

A Personal Statement is required for all applications. In addition, the following mandatory requirements must be provided at the stated sums insured. The tables over the page are a guide to minimum requirements only. The circumstances of each case will determine the need for further tests or reports. The following requirements relate to total cover with AXA and AC&L.

Special note for increases

Mandatory requirements may be waived depending on the time since commencement of the plan (or past increases) and the evidence previously requested. Our Underwriters will be able to assist you with these queries.

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Table A – Medical Requirements – Life and TPD

Current age Blood screen Mini-check

Medical examination by usual General Practitioner or Paramedical facility evaluation

Usual General Practitioner examination#

Personal Medical Attendant’s Report (PMAR)* Resting ECG

Specialist medical examination and Exercise ECG

Up to 40 $1,000,001 $1,000,001 $1,500,001 $2,000,001 $3,000,001 Not a mandatory requirement

$5,000,001**

41 – 45 $1,000,001 $1,000,001 $1,500,001 $2,000,001 $3,000,001 $2,500,001 $5,000,001**

46 – 50 $1,000,001 $750,001 $1,000,001 $1,500,001 $3,000,001 $2,500,001 $5,000,001**

51 – 55 $750,001 N/A $750,001 $1,000,001 $3,000,001 $1,500,001 $5,000,001**

56 – 60 $500,001 N/A $500,001 $1,000,001 $3,000,001 $1,000,001 $5,000,001**

61 – 65 $500,001 N/A $100,001 $1,000,001 $3,000,001 $750,001 $5,000,001**

66 + $500,001 N/A $1 $500,001 $3,000,001 $750,001 $5,000,001**

# Where the client does not have a usual General Practitioner (GP), an examination by another GP is acceptable. Should a client with a usual GP choose to be examined by another GP, we may obtain a Personal Medical Attendant’s Report from their usual GP. If an examination is performed by a GP, a Paramedical examination will not be required.

* A PMAR may not be required at these levels if the medical examination was performed by a usual doctor of at least 2 years. PMARs will be requested and organised by AXA.

** Additional medical evidence is required for cover between $5,000,001 and $10,000,000:

• Medical Examination – to be completed by a Specialist Physician (for example Cardiologist, FRACP) in all cases.

• Blood tests – PSA (if male), FBC.

• Urine tests – MSU, Cotinine (if a non-smoker).

For cover in excess of $10,000,000 please contact underwriting for requirements

Table B – Medical Requirements – Trauma

Current age Blood Screen

Medical Examination by usual General Practitioner

Full Blood Count Resting ECG PSA Mammogram

Up to 40 $1,000,001 $1,000,001 $1,000,001 $1,000,001 N/A N/A

41 – 45 $750,001 $750,001 $1,000,001 $1,000,001 N/A N/A

46 – 50 $500,001 $750,001 $750,001 $1,000,001 N/A N/A

51 – 55 $500,001 $500,001 $500,001 $750,001 $500,001 $500,001

56 – 60 $250,001 $250,001 $250,001 $250,001 $500,001 $500,001

61 – 67 $1 $1 $1 $1 $1 $1


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Important notes

Please read the following notes carefully:

1 These medical requirements relate to total standalone cover – proposed and existing with AXA and AC&L. Table A is based on the highest sum insured between Life and TPD. Table B is based on total Trauma insurance.

2 Medical examiners must not be a relative of the proposed insured, the Adviser, Broker or their families, nor a business associate of the proposed insured.

3 The maximum TPD sum insured available from all sources is $3,000,000.

4 The maximum Trauma Recovery sum insured available from all sources is $2,000,000.

5 Half of Double TPD sum insured and Double Trauma sum insured will be taken into consideration for the purposes of calculating the total sum insured.

6 For applications for Trauma cover in excess of $1,000,000, please contact the Underwriting Department for specific requirements.

7 A Personal Medical Attendant’s Report (PMAR) may be obtained on a discretionary basis where any required medical examination was not performed by the proposed insured’s usual General Practitioner and more specific information is required.

8 A Blood Screen plus Hepatitis B Surface Antibody (anti-HBS) test will be required in all cases for doctors, dentists and surgeons applying for:

Occupationally Acquired HIV, Hepatitis B and C Option under the Income •

Insurance Plus Plan.

9 For the Business Solutions Option, medical requirements will be requested up-front based on the original sum insured plus the Business Solutions Option sum insured amount.

This option is only available to medically standard lives•

Medical evidence is generally not required when exercising the Business Solutions •

Option (some exceptions apply based on the amount of the increase)

Please refer to the relevant Product Disclosure Statement or plan document

10 Cotinine blood testing may be randomly requested at sums insured over $750,000 for non-smokers.

Financial limits – mandatory requirements

Financial requirements for life cover

The table overleaf is a guide to minimum financial requirements. The circumstances of each case will determine the need for further evidence. The following requirements relate to total cover with all companies.

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Sum InsuredFinancial requirements for Life cover and TPD cover (based on highest sum insured)

Up to $2,000,000

1 Occupation and income details to be disclosed on the personal statement

$2,000,001 to $5,000,000 for Personal Insurance

1 Adviser Report2 Financial Questionnaire

$5,000,001 and over for Personal Insurance

1 Adviser Report2 Financial Questionnaire (signed by Accountant)3 Individual Income Tax returns and assessment notices for the last

two years4 If self-employed or employed by own company, audited detailed Profit

and Loss Accounts, Balance Sheets, notes to accounts for the last two years for all business entities and Company Tax Returns

$5,000,001 and over for Personal Loan Insurance

1 Adviser Report2 Financial Questionnaire (signed by Accountant) including an

explanation of why this person is responsible for the loan repayment to the extent of the sum insured applied for

3 Copy of Loan Agreement showing approval and all loan details4 If self-employed or employed by own company, audited detailed Profit

and Loss Accounts, Balance Sheets and notes to accounts for the last two years for all business entities

$2,000,001 to $3,000,000 for Business Insurance

1 Adviser Report2 Financial Questionnaire

$3,000,001 and over for Key Person Insurance

1 Adviser Report 2 Financial Questionnaire (signed by Accountant) 3 Audited detailed Profit and Loss Accounts, Balance Sheets and notes to

accounts for the last two years for all business entities$3,000,001 and over for Business Succession Insurance

1 Adviser Report2 Financial Questionnaire (signed by Accountant) 3 Audited detailed Profit and Loss Accounts, Balance Sheets and notes to

accounts for the last two years for all business entities4 Copy of buy-sell agreement (if applicable)5 Independent business valuation

$3,000,001 and over for Business Loan Insurance

1 Adviser Report2 Financial Questionnaire (signed by Accountant) 3 Audited detailed Profit and Loss Accounts, Balance Sheets and notes to

accounts for the last two years for all business entities4 Copy of loan agreement showing approval and all loan details


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Please note that any additional documentation may help to streamline the underwriting process, as the Underwriter must establish that the benefits and the amount applied for match the need.

Financial underwriting considerations – personal and businessBy financially underwriting, we aim to identify and accept risks on the basis of a clearly illustrated need for the cover being sought.

Although financial underwriting is generally applied to large sums insured, the need should be clear with all risks regardless of the sum insured. Sums insured in excess of need, in some instances, are associated with ‘anti-selection’ and a higher rate of claim.

The Underwriter must establish that:

premium payments can be sustained by the premium payer; and•a claim will not leave the policy owner/beneficiary in a better financial position than •they would have been in if the person insured had continued to live or had remained in good health.

Insurance needs generally fall into the categories of Personal Insurance (refer to page 35) or Business Insurance (refer to page 36).

The sum insured is usually based on the income an individual generates by his or her own activity (after expenses but before tax). This income is referred to as ‘personal exertion income’. Unearned income (for example, interest, rent or dividends) is not taken into consideration when calculating the sum insured unless it ceases on the insured’s death or disablement.

Maximum cover amounts

TPD

The maximum cover amount for TPD is currently $3,000,000 (from all sources) for income earning applicants. Non-income earning applicants (other than home makers) are generally restricted to $750,000 (from all sources). Refer to page 36 for details regarding home makers.

Activities of Daily Living (ADL) TPD

The maximum cover for ADL is $2,000,000 and may be used to increase the total TPD cover to $5,000,000.

Please note, to choose both types of TPD, you must first select $3,000,000 worth of TPD before you can select any ADL TPD amount. This is not necessary where you are purchasing ADL TPD only.

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Trauma

The maximum cover amount for Trauma is $2,000,000 (from all sources) for income earning applicants. For trauma cover in excess of $1,000,000 please call an Underwriter in advance for advice regarding requirements. Non-income earning applicants (including home makers) are generally restricted to $750,000 (from all sources).

Financial underwriting for personal insurance

The aim of personal insurance is to protect dependants from any financial loss arising from the insured’s death, disability or the occurrence of a traumatic event.

Personal insurance generally includes insurance for:

personal and/or family protection;1

personal loan protection (that is, loans that are repaid using personal income); and2

non-personal exertion income earner protection.3

1 Personal and/or family protection

Life Cover

This type of cover is intended to insure the loss of future personal exertion income caused by the death of the insured.

Personal exertion income is the income an individual generates by his or her own activity (after expenses but before tax). Unearned income (for example, interest, rent and dividends) is not taken into consideration when calculating the sum insured unless it ceases on the person insured’s death.

Financial evidence may be requested if the income disclosed does not appear to support the benefit proposed.

The most common method of calculating a sum insured for family protection is to use a simple multiple of annual personal exertion income.

We will take into consideration factors such as liabilities and the age and number of dependants and the number of years they will need support. Any other information you believe is relevant would be helpful to us. The following table may be used as a guide for calculating an appropriate amount of life cover.

Person to be insured’s age Multiple of personal exertion income

Up to 39 Up to 20

Up to 49 Up to 15

Up to 59 Up to 10

60 and over Up to 5

Applications for cover in excess of $2,000,000 must be supported by additional financial evidence as set out in the table on page 32.


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Trauma

This type of cover is intended to assist the person insured with the expenses and associated lifestyle changes expected in the event of a major trauma.

Unlike Life and TPD insurance, a trauma event does not necessarily result in the insured’s death or inability to work.

The sum insured should not represent a ‘wind fall’ gain to the policy owner or beneficiary. For this reason, total Trauma insurance will generally be calculated using up to 50% of the multiple used to calculate life cover.

For cover in excess of these multiples, we will initially require an Adviser Report to explain how the sum insured was determined and the need for the cover, before consideration is given.

The current maximum sum insured for income earning applicants for Trauma is $2,000,000 (from all sources). Additional requirements are necessary over $1,000,000 and must be discussed in advance with an Underwriter.

TPD

This type of cover is intended as a lump sum income replacement so it is important to ensure the cover is not excessive when compared to personal exertion income.

As a guide, the total TPD sum insured will generally be restricted to a multiple of up to 10 times annual personal exertion income. The multiple may vary depending on the age of the insured, financial needs, commitments and the total number of dependants and their ages.

For cover in excess of these multiples, we will initially require an Adviser Report detailing the reason for cover and explaining how the sum insured was calculated.

The current maximum sum insured for income earning applicants for TPD is $3,000,000 (from all sources).

2 Personal Loan Protection

In the majority of cases, personal loan protection is requested to cover a mortgage. This type of cover is intended to protect the lender from financial loss upon the premature death or disablement of the borrower.

The Underwriter will take into consideration the amount of the loan, the duration of the loan, the reason for the loan, the reputation of the lending service, the capacity to repay the loan and any other insurance on the life or disablement of the person insured.

Generally, the amount of loan cover required will be adequately accommodated when using the multiple of personal exertion income method mentioned in the Personal and/or Family Protection section above.

Applications for cover in excess of $2,000,000 will need to be supported by additional financial evidence as set out in the table on page 32.

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3 Non-personal exertion income earner protection

This type of cover is usually proposed to insure joint debt commitments and/or the financial responsibility for dependants. Applicants for this type of insurance include home makers and students. Cover for students will generally be limited to $500,000.

For home makers, Life, Trauma and TPD amounts up to $750,000 will generally be considered on the basis of information in the personal statement. However, higher amounts of Life and TPD cover* may be considered subject to the receipt of statement from the person to be insured containing the following information:

the need for the cover and how the cover amount was determined;•the personal exertion income of the income generating spouse/partner, if applicable;•unearned income details (for example, interest, rent or dividends);•assets and liabilities of the family unit;•the total number and type of dependants and their ages; •any existing insurance in force on both the income-generating spouse/partner. It •is preferable that the income-generating spouse/partner has at least an equivalent amount of cover; and

any other helpful information (for example, a child with an ongoing sickness).•

*Maximum sums insured for home makers are set at:

Life $3,000,000•TPD $2,000,000•Trauma $750,000•

Applications for life cover in excess of $2,000,000 must be supported by additional financial evidence (as set out on page 32).

Financial underwriting for business insurance

Business insurance generally includes insurance for:

1 Key person protection;

2 Business protection – Shareholder and Partnership protection; and

3 Business loan protection.

1 Key person protection

Life and TPD

This type of cover is intended to protect a business from the negative effects on trading caused by the death or total disablement of any person whose presence is considered vital for its continued wellbeing.


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These key people are employees to whom profits can be directly attributable. They may possess sound knowledge and experience in a specific field of business, and have valuable personal contacts.

Key person insurance is intended to cover such things as a loss of profitability within the business, the cost of recruitment and the training of replacement staff with specialised skills or knowledge.

The need for key person cover is mainly evident in the small to medium-sized business sector. Generally the larger the business, the less vulnerable they are to the loss of one employee.

Important considerations for key person protection

Type of business and performance of business over the last 2 years – it must be a •profitable ongoing concern.

Details of the management structure.•Who are the key people? Why are they key people?•What is the total salary bill for the business?•Are all key people being insured? If not, why?•What other insurance cover is in place?•Significant shareholders are not automatically key personnel. We will need to •ensure the individual is active in the company and that he or she is essential to its continued existence.

Often key person cover turns out to be business loan protection. These Applications •can be assessed under the guidelines for business loan cover, however we need to understand why the applicant being insured is not the company owner.

Calculating the sum insured for key person protection

There are different methods for calculating the sum insured based on either the earnings of the key person or the company profits.

The most common method is to adopt a multiple of remuneration method. This is a sensible calculation basis for employees with no ownership in the business as in many cases, their salary should reflect their value to the company.

The sum insured is calculated by multiplying the key person’s annual remuneration package by 5 to 10 times. This depends on the size of the company, the age of the key person and the time it will take to replace them. If the plan proceeds are taxable to the company, then a higher multiple may be used.

An alternative method is to base the sum insured on the sum of various cost impacts including:

recruitment and relocation costs;•any training costs;•

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costs associated with short term contractors;•advertising expenses; and•replacement salary to attract an appropriate replacement•

For more information concerning key person insurance, refer to AXA’s Technical Insurance Guide for Advisers.


Trauma

Unlike Life and TPD insurance, a trauma event does not necessarily result in the insured’s death or inability to work. It is fair to say that it is likely that the insured will be absent from work for some period of time but the period of time will depend on the trauma event suffered.

For this reason cover will generally be calculated using up to 50 per cent of the multiple used to calculate the life cover.

2 Business Protection – Shareholder and Partnership Protection

Normally, business partners will want their business to continue after the death or total disablement of one of the partners. The basic principle behind this insurance is to provide cover on all partners in a business.

The cover on each shareholder or partner should be proportionate to their respective shareholding in the business. On death or disablement, the policy proceeds provide a lump sum to allow the remaining partners to purchase the deceased or disabled partner’s share in the business.

This form of insurance enables the business to continue with a minimum of disruption by:

supplying an amount of cash for purchase of the insured’s share of the business; and/or•excluding the involvement of the insured’s beneficiaries in the day-to-day running of •the operation (for which they may not possess the knowledge or skill).

Important considerations for business protection

Each partner’s percentage share in the business.•The value of the business including the method used in deriving the valuation.•Details of any other business partner insurance cover.•Are all partners being insured? If not, why?•The business must be a profitable ongoing concern with positive net assets.•Financial evidence must be recent and freely available.•The value of company shares if listed on the stock market.•


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Existence of a Buy–Sell agreement as part of an overall business succession plan.•Existence of a cross-purchase agreement between partners.•

Calculating the Sum Insured for business protection

Value of the business and the method used will be required.•We will only cover the percentage of the business that the insured owns.•We may reduce the sum insured where the Application overlaps with other •in-force coverage, or if there are other underwriting considerations.

Allowances can be made for tax implications.•

For more information concerning business insurance, refer to AXA’s Technical Insurance Guide for Advisers.

Applications for cover in excess of $2,000,000 will need to be supported by additional financial evidence such as a recent independent market valuation, as set out in the table on page 32.

3 Business loan protection

This type of cover is intended to protect a lender from financial loss from the death or disablement of a business owner who is liable for the repayment of money borrowed by the company.

The insurance provides a lump sum on the death or disablement of the insured to repay all or part of a loan.

Important considerations for business loan protection

Duration – policy term should match the loan terms.•Loan – reason for new loan; reason for re-financing; reputation of lending institution; •percentage of loan covered; who is the guarantor?

Capacity – ability to pay premium; business performance last 2 years; will the servicing •capacity be affected by the loss of the insured?

The company must be a profitable ongoing concern and borrowing must not be for •operating costs, or for capital injection.

Has the lending institution requested that insurance be effected?•Details of other insurance in force.•Have the funds been drawn down?•Why is this person responsible for the loan repayment and what will happen to the •repayments if he/she dies?

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What is the person to be insured’s share of liability?•Are all guarantors taking the appropriate levels of insurance? If not, why?•

Calculating the sum insured for business loan protection

Percentage of loan the insured is responsible for.•If the loan is being granted to joint borrowers, the sum insured should be based on the •amount for which each borrower is responsible. We will generally not allow each life to be covered for the full amount of the loan in these circumstances.

Reduce the sum insured if loan servicing capacity will be unaffected by the loss •of the insured.


Financial underwriting – Business Solutions OptionThe Business Solutions Option is a benefit that allows clients to apply each year for increases in the sum insured under Life, Trauma and TPD cover without the need for medical underwriting after the initial assessment. Please refer to the plan documentation for full details.

The option has been designed for Business Insurance where the purpose of cover is:

Key Person Protection•Loan Protection•Business Protection (Shareholder and Partnership Protection)•

The maximum sums insured that a client can increase the sum insured to by exercising the option are:

Life – the lesser of $15 million or the original sum insured plus four times the Business •Solutions Option amount under the plan

Trauma – the lesser of $2.0 million or the original sum insured plus four times the •Business Solutions Option amount under the plan

TPD – the lesser of $3.0 million or the original sum insured plus four times the •Business Solutions Option amount under the plan

Please note that the maximum cover amounts for Trauma and TPD apply across all policies whether with AXA or not.

During the initial application the client will be fully medically underwritten for the potential final sum insured (refer page 30 for the medical requirements table). The option is only available to lives who are medically standard rates.

Financial requirements at application stage will be based on the initial sum insured and the reason for cover. Details of occupation, residence, pastimes and other insurance will be required at each increase, using a current Application Form.


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Increases – financial requirements for Business Solutions Option

In addition to the mandatory financial requirements based on the total sum insured (see page 32), the minimum financial requirements at the time of each increase are as follows:

Key Person Insurance:

Tax Returns and assessment notices of the insured, or a letter from the company •accountant detailing remuneration since last application;

Confirmation from the company accountant of the performance of the company; and•Confirmation of why the client is a key person, and who else in the company is •a key person.

Loan Protection Insurance:

Bank documentation regarding the current status, details and reason for the loan;•Reason for the increase in loan amount; and•If there is a new loan, we require a copy of the new loan agreement.•

Business Protection Insurance:

Business Financial Accounts and Tax Returns for the years since last application;•Details of the • insured’s share in the business; and

Independent valuation of the business.•

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Underwriting – Income Insurance and Business ExpensesAdviser Easy Reference Guide to Insurance

General informationIncome Protection policies are designed to replace a proportion of personal exertion income when the person insured is totally disabled and unable to work as a result of illness or injury.

The ‘quick test’ of whether income is personal exertion income is to ask, ‘If the person is unable to work, will this income cease?’ See ‘Insurable Income’ on page 45 for a definition of income.

The benefit paid under this type of policy is restricted to a maximum of 75% of the person insured’s personal exertion income. This amount is intended to replace a reasonable proportion of insurable income, yet ensure there is a financial incentive to return to work.

Replacement of income ratios are currently considered on the following basis:

75% of the first $250,000 •50% of the next $150,000, and •25% of the next $390,000.•

Note – the Underwriter may restrict this to a lesser amount after considering all risk factors.

The maximum amount of cover available is also subject to set maximums for certain occupation categories and the business rules at the time of application. For example, the current maximum amount of cover for a professional person is $30,000 per month.

Third party ownershipApplications should normally be submitted on an ‘own life’ basis, as the recipient of the policy proceeds must be the person insured. The only exceptions are as follows:

(a) Where the person insured is the chief executive and principal owner of the company (minimum 25% shareholding). In other words, where the person insured and company are one and the same entity

(b) The person insured wishes the policy to be owned by their family trust (or family company)

(c) Where a professional partnership is involved, or

(d) Where a Self Managed Superannuation Fund (SMSF) is the owner. The SMSF is responsible for any superannuation compliance and taxation requirements.

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The following mandatory requirements must be provided at the stated monthly benefits and above. The tables below are a guide to minimum requirements only.

Medical Limits – Income Insurance & Business Expenses

Current age Blood Screen PMAR Mini-check

exam

Up to 40 $7,501 $10,001 $25,001

41 – 45 $7,501 $10,001 $25,001

46 – 50 $6,501 $10,001 $25,001

51 – 55 $6,001 $7,501 $25,001

56 – 60 $6,001 $1 $25,001

60 – 65 (Senior Professional Plan only) $1 $1 –

Important Notes:

Personal Statement required in all instances•Requirements based on the highest monthly benefit between Income Insurance •and Business Expenses held with AXA and AC&L.

PMAR = Personal Medical Attendant’s Report (where there is no family doctor, a medical •examination by any doctor, not a business partner, family member etc, will be required).

Blood Screen = HIV Blood Test, Fasting MBA20, Hepatitis B & C Serology.•If the Occupationally Acquired HIV, Hepatitis B and C Option is proposed, a Blood •Screen plus Hepatitis B surface antibody test will be required.

Financial and maximum monthly benefit limits – Income Insurance & Business Expenses

Occupational Groups/PlanFinancial Evidence Required

(Agreed Value only)Maximum Monthly

Benefit (Industry wide)

MP $10,501 $30,000

AA $10,501 $30,000

A $8,501 $30,000

B $5,501 $30,000

C $4,501 $30,000

D $3,501 $30,000

F N/A $3,500

Mining industry See occupation group above $6,500

Senior Professionals Plan* See occupation group above $6,000

Business Expenses (BE) See following table $40,000

* Note that the maximum replacement ratio for the Senior Professionals Plan is up to 50% of personal exertion income


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Financial requirements – Business Expenses (BE)

Less than or equal to $10,000 per month More than $10,000 per month

Business Expenses Questionnaire Business Expenses Questionnaire

Profit & Loss Accounts for the last 2 years

The Business Expenses Questionnaire can be found in the Personal Statement.

Insurable income explainedEmployees – if the person insured is employed, (no ownership in employer’s business) his or her income is their total salary package, including commissions, regular bonuses and fringe benefits, (that income which will cease if the person cannot work). We will average commissions and bonuses to ensure over-insurance does not occur.

The waiting period should be adjusted to match any sick pay period given by the employer.

Insurable income does not include investment or interest income.

Self-Employed – if the person insured owns part or all of a business or they are a working director, income is money generated by the business due to the person insured’s own activity, after all expenses in earning that income have been deducted, that is, the income which will cease if the person cannot work.

Care should be taken when drawings are used in the calculation of insurable earnings. We will need confirmation that drawings represent entitlement to the current year’s net business profits and are not a withdrawal of capital from the business or drawings from profits earned in previous years.

For the purposes of calculating an individual’s personal exertion income, the amount of depreciation allowable for adding back is limited to a maximum of 10 per cent of the gross turnover or the amount of depreciation (whichever is the lesser).

Insurable income does not include investment or interest income.

Superannuation contributionsYou may include any superannuation contributions in your insurable income which will be subject to the replacement of income ratios on page 43. Alternatively, you may insure 100 per cent of your 9 per cent Superannuation Guarantee contributions and not have your superannuation contributions included in the replacement of income ratios. If you select this option, we will pay a proportion of the benefit to a complying superannuation fund in the event of a claim.

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Indemnity insuranceMandatory financial evidence is not required for indemnity cover. However, the Underwriter may in some cases request discretionary financial evidence to clarify the income disclosed.

The benefit amount proposed should be based on the income earned in the two years prior to application. The Underwriter aims to ensure that the client is not over-insured. At claims stage, financial evidence will be obtained to establish pre-disability income.

Farmers – (‘F’ occupation rating) This occupation category is specifically for individuals who own and work their own property on a full-time basis or who have been full time share farmers for three years or more. The benefit is calculated based on 30 per cent of the gross farm turnover to a maximum of $3,500 per month. If the client is a share farmer or part-owner, the farm share split must be determined and will be a portion of the 30 per cent of the gross farm turnover (to the maximum $3,500 per month).

Agreed value financial underwriting up-frontAs part of our underwriting and claims philosophy, we would prefer to complete our evaluation of agreed value benefits eligibility at the time of underwriting. In the event of a claim, it is preferable that your client not have to provide financial evidence to support the Total Disability Benefit.

When submitting an Application for an agreed value contract, your client will have the option of providing full financial evidence up front or accepting that benefits will be subject to future financial confirmatory evidence. The individual circumstances of the client will determine the type of financial evidence. If the evidence is considered satisfactory (see below) we will issue your client with a letter confirming that financial evidence will not be required in the event of a claim for Total Disability Benefits.

Please note that should the claim require a Partial Disablement Benefit to be paid, or benefit to be reduced by money received under legislation or another plan, further financial evidence may be requested at that time to provide evidence of pre-disability earnings.

Acceptable Financial Evidence for Agreed Value Income Protection – ‘Getting it right first time’

Employees (no ownership in the employer’s company)

PAYG payment summaries for last 2 financial years; or•3 consecutive pay slips (as long as year to date earnings are displayed) for pay periods •within the last 6 months; or

A letter from the company accountant on company letterhead confirming the full •remuneration package, including a breakdown of all packaged items for the last 2 years; or

Individual Tax Returns and Assessment Notices for the last 2 financial years.•


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Self-employed Applicants (including working directors, partners)

Verified detailed profit and loss accounts and balance sheets for all of the business •entities (including any service companies and family trusts) over the last 2 financial years. These accounts are to include Notes to the Accounts; and

Company Tax Returns and Assessment Notices for all entities for the last 2 financial •years; and

Individual Tax Returns & Assessment Notices for the last 2 financial years; and•Letter from Accountant with details of any income splitting arrangements (if •applicable). We will also require the spouse’s Tax Returns & Assessment notices for the last 2 financial years.

Sole traders

Individual Tax Returns and Assessment Notices, including details of all business •expenses with profit and loss statement to be attached, for the last 2 financial years.

Unacceptable Financial Evidence for Income ProtectionFor employees – letter from someone in company other than the company •accountant and/or not on company letterhead.

For self-employed, letter from accountant in lieu of the above.•Unverified accounts (including MYOB or Quicken print outs).•Business Activity Statements.•Invoice books or bank statements.•Tax Returns without Assessment Notices.•Assessment Notices without Tax Returns.•Previous owner’s financials.•Projected income spreadsheets.•Incomplete accounts.•

Unearned incomeUnearned Income is income that will continue if the person insured is unable to work. Unearned income includes investment and interest income. Substantial amounts of net assets can also generate unearned income.

It is important to consider unearned income at the policy Application in order to avoid over-insurance. It is essential to ensure that there will be sufficient financial incentive to return to work after a period on claim. Unearned income of up to 15% of earned income can usually be ignored, however any amounts in excess of this may be deducted from the proposed benefit at underwriting and/or the benefit period may be restricted to 2 or 5 years.

The approach taken by the Underwriter will depend on the individual circumstances.

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Income splittingIncome Splitting allows the income-generating individual to pay income, generated by their own personal exertion, as a wage to his or her spouse for minimal work in the business (for example, clerical duties). This ensures the Applicant’s own personal income is not forced up into a higher tax bracket.

If it is made clear to the Underwriter that this exercise is occurring, the spouse’s wages can be added back into the calculation to determine the person insured’s net income.

A quick test here is to be able to confirm that, if the spouse was unable to work, this income share would not have to be paid as a wage to someone else to perform functions necessary to the business.

Cover will not be issued to the spouse based on split income if it has already been used in the calculation of the main income earner’s net income.

Business Expenses insuranceBusiness Expenses insurance is designed to cover the expenses that a business continues to incur when the person insured is totally disabled.

Determining the need

The following people may be able to demonstrate a need for Business Expenses cover, provided they incur fixed overheads in the conduct of their business:

a self-employed person in a clearly defined profession or occupation, especially sole •traders; and

professional partnerships of no more than 5 partners including the insured.•

Types of business expenses covered

This insurance covers expenses incurred in the operation of the business during the period of a claim, that are essential to producing business income. The intention is to ensure that, after a limited period of disability, the insured person has a business to return to. Expenses covered include:

salaries, fringe benefits tax (FBT) and employer costs (for example, superannuation) in •relation to the salaries of non-income generating employees;

office rent or the regular interest payment on a business loan or mortgage;•leasing of equipment and motor vehicles for business use;•laundry, cleaning, electricity, gas, water, telephone; ongoing bank charges and fees;•accounting fees and dues to professional bodies;•net cost of a medical locum (where fees incurred for the locum exceed the income •generated by the locum);

property rates and taxes (for example land tax); and•general insurance premiums.•


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Note: This is pure indemnity insurance. We only pay for actual costs incurred up to the value of the benefit amount. It is the insured person’s responsibility to ensure they are neither over nor under insured over time. Offsets apply to this cover, please contact the underwriting team if you require clarification.

Types of business expenses not coveredGoods, wares, merchandise or trade in stock.•The cost of the implements of the person insured’s profession, business or occupation •(for example, the cost of a carpenter’s tools).

Salaries, fees, drawing accounts or any other form of remuneration to the client, •his/her replacement or any other person who directly contributes to the earnings of the client or the business (excluding the net cost of a medical locum).

Salaries paid to non-working spouses.•remuneration, however paid, to members of the person insured’s family (unless they •were employed at least 30 days prior to total disablement and they do not directly contribute to earnings).

Any expenses which are not fixed and ongoing.•Any taxes (unless associated with the salaries of non-income •generating employees).

Outgoings of the business (some common examples seen on profit and loss •accounts are personal superannuation, personal motor vehicle expenses, entertainment, donations).

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Product informationAdviser Easy Reference Guide to Insurance

Life Insurance Plan

Minimum sum insured $50,000

Maximum sum insured No limit, subject to reinsurance

Minimum premium $250 across linked plans

Entry ages 11 – 70 stepped next birthday11 – 65 level next birthday*

Expiry ages 99

Benefits available Death, Financial Plan, Indexation, Advancement of Funeral Expenses, Interim Accidental Death Cover, Terminal Illness, 24 Hour Worldwide Cover, Upgrade of Benefits

Options available TPD, Double TPD, ADL TPD, Future Insurability, Business Solutions Option, Trauma Recovery, Double Trauma Recovery, Life Buy-Back (TPD)**, Children’s Trauma, Life Buy-Back (Trauma)†, Trauma Reinstatement†, Premium Waiver, Comprehensive Cancer†

Life Insurance Superannuation Plan


Maximum sum insured No limit, subject to reinsurance


Entry ages 11 – 70 stepped next birthday11 – 65 level next birthday*

Expiry ages 75

Benefits available Death, Indexation, Terminal Illness, Interim Accidental Death Cover, Upgrade of Benefits, Binding Nominations, 24 Hour Worldwide Cover

Options available TPD, Double TPD, ADL TPD, Future Insurability, Business solutions Option, Trauma Recovery, Double Trauma Recovery, Life Buy-Back (TPD)**, Children’s Trauma, Life Buy-Back (Trauma)†, Trauma Reinstatement†, Premium Waiver, Comprehensive Cancer†

* Level premiums will alter to stepped premiums after age 70.

** Available only when TPD Insurance is bought as an option. † Available only when Trauma Recovery Insurance is bought as an option.

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Trauma Recovery Insurance Plan/Option


Maximum sum insured $2,000,000*


Entry ages Stepped 16 – 68 next birthday Level 16 – 60 next birthday†

Expiry ages 99. However, after the first renewal date after the insured turns age 70, the plan will only provide cover for ‘loss of capacity for independent living’

Benefits available Upgrade of Benefits, Financial Plan, Indexation, Interim Accidental Trauma Recovery Cover, 24 Hour Worldwide Cover

Options available Children’s Trauma, Business Solutions Option, TPD, ADL TPD, Life Buy-Back – Trauma**, Trauma Reinstatement , Comprehensive Cancer

Events covered Adult Insulin Dependent Diabetes, Alzheimer’s Disease and other Dementias, Angioplasty, Aplastic Anaemia, Benign Brain Tumour, Blindness, Cancer, Cardiac Arrest, Cardiomyopathy, Chronic Kidney Failure, Chronic Liver Disease, Coma, Coronary Artery Bypass Surgery, Deafness, Diplegia, Encephalitis, Heart Attack, Heart Valve Surgery, Hemiplegia, Loss of Capacity for Independent Living, Loss of Limbs, Loss of Speech, Lung Disease, Major Head Injury, Major Organ Transplant, Medical Condition Requiring Life Support, Medically Acquired HIV, Motor Neurone Disease, Multiple Sclerosis, Muscular Dystrophy, Occupationally Acquired HIV, Paraplegia, Parkinson’s Disease, Pneumonectomy, Primary Pulmonary Hypertension, Quadriplegia, Severe Burns, Stroke, Surgery of the Aorta, Triple Vessel Angioplasty

* The standard maximum cover amount for Trauma is $2 million (from all sources) for income earning applicants.

** Available only when the Trauma Recovery Insurance is bought as an option only.† Level premiums will alter to stepped premiums on the first renewal date after age 65.


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Total and Permanent Disability Insurance Plan/Option





Expiry ages 99. However, after the first renewal date after the insured turns age 65, the plan will only provide cover for ‘future care’, ‘specific loss’ and ‘significant cognitive impairment’

Benefits available Specific loss, unable to work, unable to perform domestic work, future care, 24 Hour Worldwide Cover, Indexation, Upgrade of Benefits, Financial Plan, Loss of use of one hand or one foot or the entire sight in one eye

Options available Business Solutions Option, Life Buy-Back – TPD**

* The standard maximum cover amount for TPD is $3.0 million (from all sources) for income earning applicants

** Available only when the TPD Insurance is bought as an option only† Level premiums will alter to stepped premiums on the first renewal date after age 65

Activities of Daily Living (ADL) Total and Permanent Disability Insurance Plan/Option





Expiry ages 99

Benefits available Upgrade of Benefits, Financial Plan, Activities of Daily Living, ‘significant cognitive impairment’ (from the renewal date after the insured turns age 65), 24 Hour Worldwide Cover, Indexation

Options available None

* The standard maximum cover amount for ADL TPD is $2.0 million (from all sources) for income earning applicants † Level premiums will alter to stepped premiums on the first renewal date after age 65

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56

Inco

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efit

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iod

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Y

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30 d

ays

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0, 6

0, 9

0,

180,

365

, 730

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N/A

14, 3

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0, 9

0,

180

days

N/A

N/A

Age

6030

, 60,

90,

180

, 36

5, 7

30 d

ays

14, 3

0, 6

0, 9

0,

180,

365

, 730

da

ys

N/A

14, 3

0, 6

0, 9

0,

180

days

N/A

N/A

5 Ye

ars

30, 6

0, 9

0, 1

80,

730

days

14, 3

0, 6

0, 9

0,

180

, 730

day

s30

, 60,

90,

180

, 73

0 da

ys14

, 30,

60,

90,

73

0 da

ysN

/AN

/A

2 Ye

ars

30, 6

0, 9

0, 1

80

days

14, 3

0, 6

0, 9

0,

180

days

30, 6

0, 9

0, 1

80

days

14, 3

0, 6

0, 9

0 da

ys14

& 3

0 da

ys30

day

s

30, 6

0 da

ys

(Sen

ior

Prof

essio

nals)

N/A

N/A

N/A

N/A

N/A

1 Ye

arN

/AN

/AN

/AN

/A14

& 3

0 da

ys30

day

s

30, 6

0 da

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(Sen

ior

Prof

essio

nals)

N/A

N/A

N/A

N/A

N/A


The

tab

le b

elo

w s

um

mar

ises

th

e al

low

able

co

mb

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ion

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f B

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it Pe

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ds

and

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.

57

Business Expenses Insurance Plan


Maximum Benefit Amount $40,000 per month

Entry ages 18 – 60 next birthday

Expiry ages 65

Occupations MP, AA, A, B, C, D

Waiting periods 30, 60, 90 days 14 day waiting periods available to B or C

Benefits available Total Disability, Attempted Return to Work, Recurrent Disability, Death, 24 Hour Worldwide Cover, Indexation, Upgrade of Benefits, Waiver of Premium, Locum Cover

Options available N/A

58

Large case discounts

Sum Insured Band Life Trauma Plan Trauma Option TPD Plan TPD Option

0 – $249,999 0% 0% 0% 0% 0%

$250,000 – $499,999 8% 11% 18% 4% 3%

$500,000 – $749,999 26% 19% 23% 20% 11%

$750,000 – $999,999 27.5% 20% 23% 25% 13%

$1,000,000 – $1,999,999 34.5% 20% 23% 26% 14%

Over $2,000,000 35% 20% 23% 26% 14%

Sum Insured Band IP/BEP

1 – $2,999 0%

$3,000 – $3,999 3%

$4,000 – $4,999 9%

$5,000 – $9,999 12%

Over $10,000 13.5%

Sum Insured Band Senior

1 – $4,999 0%

$5,000 – $6,000 5%

Adviser Commission details

Full details of commission payable on AXA products are available in the Commission Schedule which may be downloaded from www.axaadvantage.com.au.

Changing Plan OwnershipImportant information that you need to know if your client is changing their plan ownership on Term and Total and Permanent Disablement (TPD) Insurance products.

If you are changing the plan ownership from:

an individual to a self-managed superannuation fund (SMSF),•an individual to NM Superannuation,•NM Superannuation to an SMSF,•NM Superannuation to an individual,•SMSF to an individual,•SMSF to NM Superannuation, or•SMSF to another SMSF.•


59

The existing AXA or AC&L plan must be cancelled and replaced with an equivalent on-sale AXA/AC&L Insurance Plan.

The reasons for cancellation and replacement are:

There are fundamental differences between the relationships that exist where 1 insurance is purchased by an individual and insurance is purchased by an individual through a superannuation trustee.

The policy document received by the original plan owner contains specific wording 2 depending on who owns the policy.

Where the plan owner is an individual, the policy document may have included a funeral benefit and/or financial plan benefit. These are not allowed under a superannuation arrangement.

Where the plan owner is an individual, the policy document would have usually included an age greater than age 75 for when the plan ends. This is not currently allowed under a superannuation arrangement.

Where the plan owner is an individual, the policy document would have specified any benefit paid will be paid in accordance with the plan owner’s request. This is not allowed under a superannuation arrangement. Any benefit payment would be paid to the Trustee and then paid at their discretion (provided release conditions have been met).

3 Superannuation legislation prevents a superannuation fund acquiring a life insurance policy from an individual.

As part of the replacement, AXA will provide the following for your client:

If the new plan is owned by: NM Superannuation or SMSF

If the new plan is owned by: Individual

The premium cease age for the new •AXA/AC&L Insurance Plan will be age 75 – in some instances this will be greater than the current premium cease age of the existing plan.We will not medically or financially •underwrite the new AXA/AC&L Insurance Plan provided the sum insured amount is not increasing and the current insurance is not reinsured.

The premium cease age for the new •AXA/AC&L Insurance Plan will be age 99 – in most instances this will be greater than the current premium cease age of the existing plan.We will not medically or financially •underwrite the new AXA/AC&L Insurance Plan provided the sum insured amount is not increasing and the current insurance is not reinsured.

60


Changing plan ownership – administration requirements

Application form

To complete the change in plan ownership, you must first identify the category in the Table 1.

Table 1

From Current Plan Owner To Proposed Plan Owner Category

Individual NM Superannuation A

SMSF NM Superannuation A

Individual SMSF B

NM Superannuation SMSF B

SMSF SMSF B

NM Superannuation Individual C

SMSF Individual C

Once you have determined the applicable category, please refer to Table 2 for the pages of the current Insurance Application Form that need to be completed.

Table 2

Which parts of the Application Form

Requirements to be completed according to the category held in the table above

A B C

Plan summary Yes Yes Yes

Products and options Yes Yes Yes

Superannuation membership Yes

Nomination of dependants Yes

Trustee declaration Yes

Tax file number Yes

Nomination of beneficiaries Yes

Payment authorities Yes Yes Yes

Declaration, consent and signatures Yes Yes Yes

Financial adviser checklist Yes Yes Yes

Note: If the current plan is reinsured then we may require further details. These details will be determined by the Underwriter once the Application Form has been received and may involve a request for medical and financial information.

61

Premium quoting

The standard premium rates for the new AXA/AC&L Insurance Plan will apply. The new premium can be calculated using the Premium quoting tool (PQT).

If the current premium structure is ‘stepped’, the premium quote will be based on the •client’s age next birthday. This is achieved by entering the client’s exact date of birth.

If the current premium structure is ‘level’, you will need to request your BDM to •provide you with a composite level premium age. This age will take into consideration when the original policy first commenced and any sum insured increases along the way. Once the age has been provided, you will need to enter the date of birth that returns this age in the Age Next field.

In both instances, a copy of the Insurance quote from the PQT must be submitted with the application. A copy of the BDM email with the composite level premium age should also be provided as confirmation.

There may be instances where the new stepped or level insurance premium is greater than the old insurance premium. In these instances the new stepped or level insurance premium will apply.

As part of the replacement, AXA will provide the following for you:

The new plans will be set-up with the same commission style (upfront, hybrid or flat) •as per the current plan being cancelled.

Renewal commission will be increased to the current commission terms, with •a minimum annual commission payment equal to 10.12 per cent of insurance premium received.

New business commission will be paid on any increase in premium between the •current insurance premium and the new insurance premium.

62


Workplace Rewards and Family

A packaging discount may apply if policies are grouped together because there is a ‘family’, ‘workplace’ or ‘family/workplace’ relationship between the lives insured on the grouped policies.

A ‘family’ relationship includes lives insured who are:

brothers, sisters, a son, daughter, father, mother, father-in-law, mother-in-law, brother-•in-law and sister-in-law

a spouse, or•a person in a bona fide domestic living arrangement and is financially interdependent. •The policy owner must provide us with satisfactory evidence that there is an established and ongoing interdependency.

A ‘workplace’ relationship includes the employer, employees and their spouses.

Lives insured under the Children’s Trauma Option are excluded.

Eligibility to join a program is subject to acceptance from the Financial Protection National Development Manager. The program will be activated upon successful application and the commencement of five eligible plans.

63

Occupations – generalAdviser Easy Reference Guide to Insurance

This section of the guide covers a wide variety of occupations. The tables provide suggested occupation ratings for Trauma, TPD, ADL TPD and Income Protection

Occupations should be classified based on duties not title. To assist the Underwriter, always give a full description of actual duties on the Personal Statement.

If you are unsure how to classify a particular occupation, please call the underwriting team.

Income Protection and TPD considerations

Hours worked per week

For income protection the person insured must work in a full time capacity, and be in regular employment. The minimum number of hours worked per week is 30.

Consideration may be given to permanent part-time employees working regular hours, away from home and for at least 20 hours per week. It will be preferable if the insured has established a pattern of ongoing regular, part time work for a period of at least 12 months. Special consideration will be given to waiving this 12 month requirement for qualified professionals returning to part time work from maternity or paternity leave.

The Underwriter will also carefully assess those Applicants who are working a large number of hours per week (that is over 40 to 50 hours per week), and may limit the benefit period (for example, to 2 years or 5 years), the benefit amount, or decline cover altogether.

If the Applicant has a second occupation and the combined hours are excessive, this may also result in similar underwriting action.

For TPD, cover is only available if the person insured is involved in regular permanent work for at least 20 hours per week. To be eligible for TPD, a home maker will be required to provide a statement regarding their duties running the family home and their active involvement in the full time care of dependants (including children, parents, partners or siblings).

Home maker TPD cover is not available under superannuation plans.

Seasonal employment

Income Protection and TPD cover are not available to seasonal workers. Seasonal work usually depends on conditions outside the control of the client, such as travel, climate and weather conditions. Examples of seasonal workers are fruit pickers.

Dual occupations

Many people have more than one occupation so they can supplement their main income. This may be for economic reasons or to just have additional funds for holidays.

We will assess each Application on an individual basis, however, the following guideline will usually be followed.

64

The occupation rating that will be used will be based on the highest risk occupation.•From a financial perspective, if the two occupations are not related and the client •applies for an agreed value income protection plan, we will in most cases only consider the income earned from the principal occupation.

If the two occupations are related, we may be able to consider covering both sources •of income under an indemnity only policy.

We will only consider covering the income from both occupations if the Applicant has •been working in the second occupation for at least 12 months.

Newly self-employed

In most cases we do not offer income protection for at least the first 12 months of self-employment. The reason for this is that it will usually take this period of time for the new business to establish itself, and for us to see a steady income/profit from the business.

The risk that we must bear in mind is that a large percentage of small businesses fail in the first 12 months. Cash flow problems are also a common occurrence in the first year of operation.

There are however two situations where we may consider income protection on someone who is newly self-employed. These are:

(a) People contracting back to their previous employer in the same occupation (see next section – Contractors); and

(b) People who have purchased an existing franchise or business in an industry in which they have prior experience.

Information we require should the Applicant fit into category (b) above:

background information on the business including how long it has been operating;•how much knowledge or experience the Applicant has;•the last two years’ financial accounts for the business purchased; •copies of any signed contracts to provide goods or services; and•a copy of the business plan.•

Terms and conditions we may consider:

a minimum waiting period of 30 days;•a maximum Benefit Period of five years;•indemnity cover only;•benefits will be based on the Applicant’s earnings in the last two years and the •earning history of the business purchased;

an endorsement may apply limiting benefits to a proportion of the average income of •the new business in the first 12 months;

the insured must not work from home; and•

Occupations – generalAdviser Easy Reference Guide to Insurance

65

cover will not be considered if there is a history of bankruptcy or the insured has an •unstable occupation history.

Contractors (sub-contractors)

Contract workers require special consideration when underwriting. We will consider the following:

contractors are normally responsible for all business expenses. These will need to be •deducted from the income stated in the contract;

continuing work may not be guaranteed; and•the length of the contract is a significant consideration. The longer the term of the •contract, the better the risk.

In most cases we will offer indemnity only cover with benefit periods limited to two or five years.

If the contractor has been self-employed less than 12 months, cover may not be available. Special consideration may be made for clients who have moved to a contract basis of employment, however remain working for the same company in the same position. Indemnity cover may be considered with a limited benefit period. Please call underwriting to discuss.

Working from home

A person insured who works from his or her place of residence presents a number of concerns at claims stage. It is difficult for the assessor to gauge the level of ongoing disability and the amount of work actually being performed.

Should your client work from their place of residence, the following information will be useful for the Underwriter and should be provided with the Application.

Does the office have a separate entrance open to the public?•Is the office totally separate to the living areas in the home?•Is there a separate phone line dedicated to the business?•What is the frequency and the nature of contact with clients?•What percentage of this contact is face to face?•How often and for what reasons does the insured leave the premises in order to •conduct business?

Where the client has a separate office from the main living area, and is dependent on regular face to face customer contact, a 30-day waiting period and an unlimited benefit period may be available.

Other Applications may be considered for 90-day waiting periods only, with a maximum benefit period of either 2 or 5 years.

66


67

Rating guide

Occupation rate categories

Occupation classification is determined by the duties performed not the occupation title.

Income Protection

MP Selected Medical Professionals, for example, general practitioners and psychiatrists.

AA Includes what has been traditionally referred to as ‘the professions’. In every case, training and registration by a professional or Government body is a feature. The acceptable professions are limited to those that are perceived to be the lowest risk, for example, engineers who are limited to consulting/office duties only. Includes dentists and selected medical specialists (not psychiatrists or general practitioners). This may also include individuals who are in an office based management role only, are degree qualified and are earning in excess of $150,000 per annum.

A Includes white collar workers whose duties are primarily mental and who work in an office where the work is of a sedentary nature, for example, clerks.

B Includes white collar occupations which are not primarily sedentary, for example, commercial travellers, stock and station agents. Technicians and crafts people and some retail shopkeepers (light goods) fall within this group.

C Includes occupations involving some manual duties and use of light machinery. Many qualified tradespersons come within this group, as do many retail shopkeepers.

D Includes occupations requiring heavy manual work or where there are significant accident or environment hazards, for example, earthmoving workers.

F Farmers who own and work full-time on their own properties or full-time share farmers. They must have been well established in this manner for at least 3 years.

BY, CY, DY These occupations are only eligible for yearly renewable business.

NA The risk is not acceptable – Non insurable, for example, police officer, army officer.

IC Individual consideration required.

Important note: Some applications may require different terms than those indicated above due to individual circumstances and factors other than the current occupation title.

Occupation rating guideAdviser Easy Reference Guide to Insurance

68


TPD and Trauma

B, C, D, E A multiple of the basic or standard premium will be charged (see Special notes below).

IC Individual consideration of the particular case is needed. Full details should be submitted with the proposal. The rating will depend on the particular circumstances of the case involved.

NA Cover is not available to persons in that occupation.

EXC A special plan condition will apply which will automatically exclude certain activities or trauma events.

Special notes

Trauma Some of the quoted ratings suggest a special plan condition (SPC) or an extra premium as an alternative. Trauma benefit ratings are expressed alphabetically, with A representing the standard rate and ratings of B and C representing multiples of the standard rate, and which are currently 1.5 and 2.0 respectively. These multiples are not the same as those which apply for TPD.

TPD and ADL TPD

Disablement insurance ratings are expressed alphabetically with A representing the standard rate and ratings of B, C, D and E representing multiples of the standard rate which are currently 1.20, 1.45, 2.00 and 2.50 respectively. These multiples are not the same as those which apply to Trauma.

‘Own’ Occupation TPD

Own Occupation TPD is generally available to medically standard lives only. These occupations are required to be 100 per cent sedentary (ie no manual work), individuals must be fully qualified in their field of expertise and hold appropriate registration. The valid occupations are as follows:

Accounts clerk

Accountant – degree

Actuary

Administration/Clerical

Advertising Executive

Aeronautical engineer

Agricultural scientist (less than 10% field work)

Aircraft engineer (non flying – not office based)

Aircraft engineer (office only)

Airport management – others (office based only)

Ambulance Personnel (administration only)

Anaesthetist

Archaeologist – Consultant

Architect

Architectural draftsperson

Astronomer

Auctioneer – Real Estate (min 3 years experience)

Audiologist

Auditor

Bank clerk

Banking administration

Banking – Senior Management

69

Barrister

Biochemist

Bookkeeper

Botanist

Brewery/Distillery – Admin, Clerical, Management

Brewery/Distillery – Chemist

Business executive

Cardiologist

Cartographer (no aviation work)

Chemical engineer (no hazardous materials)

Civil Engineer

Coroner

Dental hygienist

Dental nurse

Dental prosthetist

Dental surgeon

Dental technician

Dentist

Dermatologist

Dietician

Doctor

Draftsperson

Economist

Editor – newspaper industry

Electronic engineer

Endocrinologist

Engineer (office based)

Exporter/Importer (office only)

Gastroenterologist

General practitioner

Geneticist

Geologist (office duties)

Graphic artist/designer (not working from home)

Gynaecologist

Haematologist

Hardware/Building Supplies – Admin/Clerical/Management only

Headmaster (School)

Hospital registrar/manager

Human Resources/Personnel Manager

Importer/exporter (office only)

Industrial chemist (non hazardous materials)

Insurance clerk/administrator

Insurance manager/executive

Interior decorator (design only)

Interpreter

Judge

Lawyer/solicitor

Mathematician

Merchant banker

Metallurgist (office/ laboratory only)

Meteorologist

Neurologist

Nurse primarily engaged in administration (eg Director Of Nursing/Matron)

Nurse – dental

Obstetrician

Occupational therapist

Office worker (clerical, typist, receptionist, secretary)

Oil, petroleum & natural Gas Industries (onshore) Management/Clerical

Ophthalmic surgeon

Ophthalmologist

Optician

Optometrist

Orthodontist

Orthopaedist

Osteopath

Paediatrician

Pathologist

Pathology analyst

Personnel consultant

Pharmacist

Physician

Physicist

Plastic surgeon

Podiatrist/chiropodist

Principal (School)

Proof reader (printing and publishing)

Psychiatrist

Psychologist

Public relations officer (tertiary qualified)

Publisher

Quantity surveyor

Radiographer

Radiologist

Real estate administration/Clerical

Real estate auctioneer (3 years experience)

Receptionist

Schools – principal

70


Secretary/stenographer

Senior Executives/ Manager

Shipping/Maritime Industry Shore Personnel (administration only)

Speech therapist

Statistician

Surgeon

Surveyor – consulting

Tax consultant

Theatre/cinema Industry (management administration and full time only)

Town planner

Toxicologist

Trades/technical – lecturer

University – Lecturer/Professor/Dean

University – office administration staff

Urologist

Valuer

Veterinarian – domestic pets

Vigneron/winemaker

Zoologist (lab only)

71

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

ABA

LON

E D

IVER

NA

EXC

or

BN

A

ABA

TTO

IR W

ORK

ER (

not

SL

AU

GH

TERE

R)D

YA

NA

AC

CO

UN

TAN

T C

A/C

PA Q

ual

ified

O

ther

AA

A

A

A

A

A

AC

TOR

(see

RA

DIO

/TEL

EVIS

ION

/FI

LM IN

DU

STRY

or

THEA

TRE/

CIN

EMA

IND

UST

RY)

AC

TUA

RYA

AA

A

AC

UPU

NC

TURI

ST (

Qu

alifi

ed)

MP

AA

AC

UPU

NC

TURI

ST (

oth

er)

NA

AN

A

AER

IAL

PHO

TOG

RAPH

ER (

see

PHO

TOG

RAPH

ER)

AG

ENT

Ad

vert

isin

g

Cu

stom

s an

d S

hip

pin

g

Emp

loym

ent

Hou

se/L

and

In

sura

nce

M

ach

iner

y M

erca

ntil

e/Re

pos

sess

ion

/ Pr

ivat

e D

etec

tive

Real

Est

ate

Stoc

k/St

atio

n

Oth

er

A

C

A

A

A

B NA

A

B

IC

A

A

A

A

A

A A

A

B

A

A

B

A

A

A

B A

A

B

IC

AG

RIC

ULT

URE

(se

e FA

RMER

)

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

AIR

CO

ND

ITIO

NIN

G –

En

gin

eerin

g

Deg

ree

& o

ffice

du

ties

only

O

ffice

du

ties

Inst

alle

r

AA

A

C

A

A

A

A

A

C

AIR

FORC

E PE

RSO

NN

ELN

A

AN

AA

IRLI

NE

(see

AV

IATI

ON

IN

DU

STRY

)A

MBU

LAN

CE

D

river

/Offi

cer

Pers

onn

el (

adm

inist

ratio

n o

nly

)

D

A

A A

E AA

IRPO

RT M

AN

AG

EMEN

T (o

ffice

ba

sed

on

ly)

AA

AA

MU

SEM

ENT

PARL

OU

R/C

ENTR

E Pr

oprie

tor

– N

o. o

f em

plo

yees

>10

–

No.

of e

mp

loye

es <

10

Emp

loye

e

B

C

CY

A

A

A

A

B

CA

NA

ESTH

ETIS

TA

AA

AA

NA

LYST

/PRO

GRA

MM

ER (

see

CO

MPU

TER

IND

UST

RY)

AN

TEN

NA

ERE

CTO

R D

omes

tic O

nly

O

ther

CY

NA

A

A

D

NA

AN

TIQ

UE

DEA

LER

BA

B

APP

REN

TIC

E (1

st,

2nd

, 3r

d y

ear)

(4

th y

ear)

NA

D

Y

A

A

NA

D

72


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

ARC

HIT

ECT

AA

AA

ARC

HIT

ECTU

RAL

DRA

FTSP

ERSO

NA

AA

ARM

Y PE

RSO

NN

ELN

AA

NA

ART

IST

C

omm

erci

al (

full-

time,

not

w

orki

ng

at

hom

e)

Gra

ph

ic

Scu

lpto

r O

ther

A

A

NA

N

A

A

A

A

A

A

A

NA

N

A

AU

CTI

ON

EER

Live

stoc

k (3

yea

rs e

xper

ien

ce)

Real

Est

ate

(3 y

ears

exp

erie

nce

) O

ther

C

A

IC

A

A

A

C

A

IC

AU

DIO

LOG

IST

MP

AA

AU

DIT

OR

AA

A

AU

THO

RN

AA

NA

AU

TOEL

ECTR

ICIA

NC

AC

AU

TOM

OBI

LE (

see

MO

TOR

VEH

ICLE

IND

UST

RY)

AVIA

TIO

N IN

DU

STRY

Fl

yin

g P

erso

nn

el

– A

tten

dan

ts/P

ilot

Non

-Fly

ing

Per

son

nel

–

Air

Traf

fic C

ontr

olle

r –

Mec

han

ic/M

ain

ten

ance

Sta

ff –

Bag

gag

e H

and

ler

– O

ther

Man

ual

–

Cle

rical

NA

NA

C

D

Y D

Y A

A A

A

A

A

A

NA

NA

C

D

D

A

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

BAC

KHO

E O

PERA

TOR

DA

D

BAKE

R/PA

STRY

CO

OK

(Q

ual

ified

)

Oth

er (

2 ye

ar m

in)

C

D

A

A

C

D

BAN

AN

A F

arm

er/M

anag

erC

AC

BAN

K/BU

ILD

ING

SO

CIE

TIES

A

dm

inist

rativ

e/C

leric

al/

Man

agem

ent

AA

A

BAN

KER

– M

ERC

HA

NT

AA

AA

BARB

ER

Not

Wor

kin

g a

t H

ome

Wor

kin

g a

t H

ome

CY

NA

A

A

C

NA

BART

END

ERC

YA

C

BARR

ISTE

RA

AA

A

BEA

CH

INSP

ECTO

RN

AA

NA

BEA

UTI

CIA

N

Not

wor

kin

g a

t h

ome

Wor

kin

g a

t h

ome

C

NA

A

A

C

NA

BEEK

EEPE

R/A

PIA

RIST

CA

C

BILL

IARD

SA

LOO

N

Prop

rieto

r –

No.

of e

mp

loye

es >

10

– N

o. o

f em

plo

yees

<10

Em

plo

yee

B

C

CY

A

A

A

A

B

C

BLA

CKS

MIT

H/F

ARR

IER

DY

AE

BLA

STER

(Ex

plo

sives

) D

Y EX

C o

r C

NA

73

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

BLIN

D/A

WN

ING

/SC

REEN

M

anu

fact

ure

r In

stal

ler

C

C

A

A

C

C

BOA

RDIN

G H

OU

SE P

ROPR

IETO

RN

AA

NA

BOAT

BU

ILD

ER

(Tra

dep

erso

n q

ual

ified

)C

AC

BOAT

/WAT

ERC

RAFT

OPE

RATO

R (F

ull

det

ails

requ

ired

)IC

AIC

BOBC

AT O

PERA

TOR

DA

D

BOIL

ER

Insp

ecto

r M

aker

C

D

A

A

C

D

BOO

KBIN

DER

BA

B

BOO

KKEE

PER

AA

A

BOO

KMA

KER/

BETT

ING

NA

AN

A

BOTT

LE D

EALE

RC

YA

C

BREA

D V

END

OR

CA

C

BREW

ERY/

DIS

TILL

ERY

Ad

min

/Cle

rical

/Man

agem

ent

Ch

emist

W

orke

r –

non

ski

lled

A

A

CY

A

A

A

A

A

C

BRIC

KLAY

ERD

YA

E

BRIC

KWO

RKS

EMPL

OYE

E

(non

ski

lled

)D

YA

C

BRO

KER

Fi

nan

ce/I

nsu

ran

ce/S

har

e/St

ock

AA

A

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

BUIL

DER

(Li

cen

sed

)C

AC

BUIL

DER

(w

ithou

t qu

alifi

catio

n)

DY

AE

BUIL

DER

’S L

ABO

URE

RD

YA

E

BUIL

DER

’S S

UPP

LY M

ERC

HA

NT

CA

C

BUIL

DIN

G IN

SPEC

TOR

BA

B

BULL

DO

ZER

DRI

VER

/OPE

RATO

RD

AD

BUS

DRI

VER

Lo

cal

Lon

g D

istan

ce

D

DY

A

A

C

D

BUSI

NES

S EX

ECU

TIV

EA

AA

BUTC

HER

Re

tail

Sl

aug

hte

rer

C

DY

A

AC

N

A

BUYE

R

Cle

rical

O

ther

A

IC

A

A

A

IC

CA

BIN

ET M

AKE

R (Q

ual

ified

)C

AC

CA

FE P

ROPR

IETO

RB

AB

CA

MER

A O

PERA

TOR

(See

Rad

io/

Tele

visio

n/F

ilm In

du

stry

)

CA

NE

FARM

ER/M

anag

erC

AC

CA

R SA

LESP

ERSO

NA

AA

CA

RAV

AN

PA

RK/P

ROPR

IETO

R/

EMPL

OYE

E DY

A

NA

74


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

CA

RETA

KER

DA

NA

CA

RPEN

TER

(Q

ual

ified

) (U

nqu

alifi

ed)

(Ap

pre

ntic

e)

C

D

DY

A

A

A

C

D

D

CA

RPET

CLE

AN

ERC

AC

CA

RPET

LAY

ERD

YA

NA

CA

RTA

GE

CO

NTR

AC

TOR/

CA

RRIE

R Lo

cal/

Met

rop

olita

n

Lon

g D

istan

ce

D

DY

A

AC

N

A

CA

SHIE

R– F

INA

NC

IAL

INST

ITU

TIO

NS

AA

A

CA

SIN

O

Cro

up

ier

(Min

imu

m 2

yea

rs

exp

erie

nce

) Po

ker/

Gam

ing

Mac

hin

e St

aff

Secu

rity

(see

SEC

URI

TY G

UA

RD)

Oth

er

B

C IC

A

A A

B

B IC

CAT

ERER

C

ooki

ng

N

o C

ooki

ng

C

B

A

A

C

B

CEM

ETER

Y/C

REM

ATO

RIU

M

WO

RKER

CY

AC

CH

AIN

MA

N (

SURV

EYIN

G)

DY

AD

CH

AU

FFEU

RB

AB

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

CH

EF (

Qu

alifi

ed)

(Un

qual

ified

min

imu

m 2

yea

rs

exp

erie

nce

)

C

DA

A

C

D

CH

EMIC

AL

IND

UST

RY

Not

Han

dlin

g A

cid

s, E

xplo

sives

, Ra

dio

activ

e M

ater

ials

–

An

alyt

ical

/In

du

stria

l Ch

emist

/Re

sear

ch W

orke

r w

ith D

egre

e –

Tech

nic

ian

/Lab

Ass

istan

t –

Proc

ess/

Prod

uct

ion

Wor

ker

Han

dlin

g A

cid

s, E

xplo

sives

, Ra

dio

activ

e M

ater

ials

AA

B

CY IC

A A

A IC

A B

C IC

CH

EMIS

T/PH

ARM

AC

IST

(Qu

alifi

ed)

AA

AA

CH

ILD

-CA

RE W

ORK

ER Q

ual

ified

an

d R

egist

ered

–

Wor

kin

g fr

om h

ome

– N

ot w

orki

ng

from

hom

e N

ot G

ovt.

Reg

ister

ed

NA

B

N

A

A

A

A

NA

B

N

A

CH

IRO

POD

IST/

POD

IATR

IST

– Re

gist

ered

with

Pod

iatr

ist’s

reg

istra

tion

boa

rd

– N

ot r

egist

ered

with

Pod

iatr

ist’s

reg

istra

tion

boa

rd

A IC

A A

A IC

CH

IRO

PRA

CTO

R Re

gist

ered

with

C

hiro

pra

ctor

’s re

gist

ratio

n b

oard

N

ot r

egist

ered

with

Ch

irop

ract

or’s

reg

istra

tion

boa

rd

C IC

A A

A IC

CIN

EMA

(se

e TH

EATR

E/C

INEM

A

IND

UST

RY)

75

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

CIR

CU

S PE

RFO

RMER

/WO

RKER

NA

ICN

A

CLE

AN

ER (

full

time

only

) Br

ick

Car

pet

H

ouse

hol

d

Offi

ce/F

acto

ry/S

choo

l St

reet

W

ind

ow

– u

p t

o 10

Met

res

hig

h

– ab

ove

10 m

etre

s h

igh

DY C

CY

CY

CY CY

DY

A

A

A

A

A A

A

E C

C

C

C C

NA

CLE

RIC

AL

WO

RKER

/CLE

RKA

AA

CLU

B

Ente

rtai

nm

ent

Nig

ht/

Disc

o

Priv

ate/

Excl

usiv

e –

Man

agem

ent/

Ad

min

. on

ly

– O

ther

s

NA

N

A

IC

IC

A

A A

A

NA

N

A

A

IC

CO

AC

H D

RIV

ER

Loca

l Lo

ng

Dist

ance

D

DY

A

A

C

D

CO

MM

ERC

IAL

ART

IST

(N

ot w

orki

ng

from

hom

e)A

AA

CO

MM

ERC

IAL

TRAV

ELLE

RB

AB

CO

MPO

SITO

R Ke

yboa

rd w

ork

only

O

ther

B

C

A

A

B

B

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

CO

MPU

TER

IND

UST

RY

Con

sulta

nt

Eng

inee

r/Te

chn

icia

n

– En

gin

eer

– Te

chn

icia

n

Keyb

oard

Op

erat

or O

per

ator

(n

o

keyb

oard

wor

k)

Prog

ram

mer

/Sys

tem

s A

nal

yst

Sale

s Re

pre

sen

tativ

e

A A

B

B

A

A

A

A A

A

A

A

A

A

A A

B

B

A

A

A

CO

NC

RETE

CO

NTR

AC

TOR/

PAV

ERN

AA

NA

CO

NTR

AC

TOR

(not

oth

erw

ise

spec

ified

)IC

ICIC

CO

OK

CA

C

CO

URI

ER (

see

DRI

VER

)

CRA

NEP

ERSO

N/D

RIV

ER

(oth

er t

han

Doc

k W

orke

r)

Tow

er C

ran

e O

ther

DY D

A

A

NA

C

DA

IRY

Prop

rieto

r

Del

iver

y Pe

rson

Em

plo

yee

C

C

CY

A

A

A

C

C

C

DEB

T C

OLL

ECTO

R N

o Re

pos

sess

ing

Rep

osse

ssin

g

C

DY

A

A

C

NA

76


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

DEC

ORA

TOR/

DES

IGN

ER

Des

ign

on

ly,

no

man

ual

wor

k In

terio

r/Ex

terio

r w

ith m

anua

l wor

k –

to 1

0 m

etre

s h

igh

–

over

10

met

res

hig

h

A B

DY

A A

A

A B

NA

DEL

ICAT

ESSE

N P

ROPR

IETO

RB

AB

DEM

OLI

SHER

(BU

ILD

ING

) Fo

rep

erso

n

Oth

er

CY

NA

A

A

C

NA

DEN

TAL

MEC

HA

NIC

/TEC

HN

ICIA

NB

AB

DEN

TAL

NU

RSE

BA

B

DEN

TIST

/DEN

TAL

SURG

EON

/O

RTH

OD

ON

TIST

AA

AA

DIE

MA

KER

CA

C

DIE

TITI

AN

(qu

alifi

ed a

nd

re

gist

ered

)A

AA

DIR

ECTO

R

(Ad

min

istra

tive

Du

ties

On

ly)

AA

A

DIV

ER (

Prof

essio

nal

)N

AIC

NA

DO

CKE

R/W

ATER

SID

E W

ORK

ERN

AA

NA

DO

CTO

R (M

EDIC

AL

OR

DEN

TAL)

MP

AA

DRA

FTSP

ERSO

NA

AA

DRA

INER

/DRA

INA

GE

CO

NTR

AC

TOR

DY

AD

DRE

SSM

AKE

R (n

ot fr

om h

ome)

CA

C

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

DRI

LLER

S

Offs

hor

e an

d/o

r ex

plo

sives

use

O

ther

NA

D

Y

A

A

NA

D

DRI

VER

A

mbu

lan

ce

Bulld

ozer

Bu

s/C

oach

–

Loca

l –

Lon

g D

istan

ce

Ch

auffe

ur

– (n

ot h

ire c

ar)

Cou

rier

– Bi

cycl

e –

Mot

orcy

cle

– C

ars

and

Sm

all V

ans

– Tr

uck

s (s

ee T

ruck

s be

low

) C

ran

e (o

ther

th

an D

ock

Wor

ker

and

Tow

er C

ran

es)

Dai

ry D

eliv

ery

Pers

on

Eart

hm

ovin

g a

nd

Con

stru

ctio

n

Equ

ipm

ent

Ex

plo

sives

Fo

rk L

ift

Gar

bag

e C

olle

ctor

In

stru

ctor

Lo

g H

aulie

r Ta

xi

Tow

Tru

ck

Tru

cks

– Lo

cal/

Met

rop

olita

n

– Lo

ng

Dist

ance

D

D D

DY B CY

CY C D

C D

DY C

DY B

DY

CY D D

DY

A

A A

A

A A

A

A A

A A

EXC

or

C

A

A

A

A

A

A A

A

E D C

D

B NA

C

C

C

C D

E C

D

B

C

C

C C

D

DRO

VER

/MU

STER

ERN

AA

NA

77

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

DRY

CLE

AN

ER P

ROPR

IETO

R/

MA

NA

GER

O

ther

C

D

A

A

C

D

EART

HM

OV

ING

WO

RKER

DA

D

ELEC

TRIC

AL

LIN

ES IN

STA

LLER

OR

REPA

IRER

/PO

WER

LIN

ESD

YA

NA

ELEC

TRIC

IAN

D

omes

tic o

r lig

ht

com

mer

cial

O

ther

C

ICA

A

C

IC

ELEC

TRO

PLAT

ER/E

NA

MEL

LER

CA

C

ENG

INEE

R (q

ual

ified

w

ith d

egre

e)

Airc

raft

(fl

yin

g e

nd

orse

men

t w

ill a

pp

ly)

Ch

emic

al (

non

-haz

ard

ous

mat

eria

ls)

Con

sulti

ng

/Offi

ce D

utie

s on

ly

Sup

ervi

sing

–

not

invo

lved

with

brid

ges

or

hei

gh

ts,

un

der

gro

un

d w

ork

or

exp

losiv

es

Man

ual

Wor

k –

not

invo

lved

with

brid

ges

or

hei

gh

ts,

un

der

gro

un

d w

ork

or

exp

losiv

es

Mar

itim

e –

not

sea

goi

ng

M

inin

g –

no

un

der

gro

un

d w

ork

an

d o

ffice

du

ties

only

(Re

fer

to

Min

e W

orke

r –

Prof

essio

nal

s)

Oth

er

C A

A

AA

B C

AA

IC

IC

A A

A A A

A IC

IC

C A

A B C

A IC

IC

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

ENG

RAV

ER/E

TCH

ERB

AB

ENTE

RTA

INER

NA

AN

A

EXEC

UTI

VE

(no

man

ual

wor

k)A

AIC

EXPL

OSI

VES

WO

RKER

NA

EXC

or

CN

A

EXPO

RTER

/IM

PORT

ER

– O

ffice

on

ly

– O

ther

A

IC

A

IC

A

IC

FAC

TORY

WO

RKER

CY

AC

FARM

ER/O

WN

ER (

min

3 y

ears

)C

/FA

C

FARM

HA

ND

/LA

BOU

RER/

WO

RKER

DY

AD

FARM

MA

NA

GER

(d

utie

s re

quire

d)

CA

C

FARR

IER

DY

AE

FASH

ION

DES

IGN

ERA

AA

FAST

FO

OD

/TA

KE A

WAY

PR

OPR

IETO

RC

AC

FEN

CIN

G C

ON

TRA

CTO

R Pr

oprie

tor

Emp

loye

e

D

DY

A

A

C

C

FIBR

EGLA

SS W

ORK

ERD

YA

D

FILM

IND

UST

RY (

see

RAD

IO/

TELE

VIS

ION

/FIL

M IN

DU

STRY

)

FIN

AN

CIA

L PL

AN

NER

/C

ON

SULT

AN

TA

AA

78


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

FIRE

FIG

HTE

R A

irpor

t C

ity

Exp

losiv

es

Min

es

Oil

and

Nat

ura

l Gas

Wel

l

DY

DY

NA

NA

NA

A

A

EXC

or

C

EXC

or

C

EXC

or

C

D

D

NA

NA

NA

FISH

ING

D

eep

Sea

or

Seas

onal

O

ther

NA

IC

A

A

NA

IC

FISH

MO

NG

ER

(not

fish

an

d c

hip

sh

op)

CA

C

FITT

ER A

ND

TU

RNER

C

AC

FLO

OR

CO

VER

ER/L

AYER

(li

nol

eum

/pla

stic

, n

ot c

arp

et)

DA

D

FLO

OR

SURF

AC

ER/T

ILER

/SA

ND

ERD

AD

FORE

PERS

ON

CY

AC

FOU

ND

RY W

ORK

ERD

YA

E

FREN

CH

PO

LISH

ERC

AC

FUN

ERA

L PA

RLO

UR

Fu

ner

al D

irect

or/U

nd

erta

ker

(n

o m

anu

al w

ork)

D

river

/Em

balm

er/P

all B

eare

r/O

ther

A C

A A

A C

FURN

ITU

RE R

EMO

VA

LIST

Lo

cal

Lon

g D

istan

ce

DY

NA

A

A

C

D

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

GA

RBA

GE

CO

LLEC

TOR

DY

AD

GA

RDEN

ER

Dom

estic

Lan

dsc

ape

(2 y

ears

ex

per

ien

ce)

Oth

er

C CY

A A

C C

GA

S FI

TTER

DA

C

GEO

LOG

IST

Offi

ce o

nly

(n

o fie

ld w

ork)

Fi

eld

Wor

k

A

C

A

A

A

C

GLA

SS B

LOW

ER/C

UTT

ERC

YA

C

GLA

ZIER

CA

C

GO

LDSM

ITH

/SIL

VER

SMIT

HB

AB

GO

LF C

LUB

PRO

FESS

ION

AL

Shop

, Tu

ition

on

ly

Tou

ring

C

NA

A

A

NA

N

A

GO

VER

NM

ENT

EMPL

OYE

ES

– O

ffice

Du

ties

only

AA

A

GRA

PHIC

ART

IST/

DES

IGN

ER

(Not

from

hom

e)A

AA

GRE

ENKE

EPER

/G

ROU

ND

SPER

SON

Su

per

viso

r (d

etai

l tra

inin

g/

occu

pat

ion

al h

istor

y)

Oth

er

C

D

A

A

C

D

GYM

INST

RUC

TOR

NA

AN

A

79

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

HA

IRD

RESS

ER/B

ARB

ER

Not

wor

kin

g a

t h

ome

Wor

kin

g a

t h

ome

CY

NA

A

A

C

NA

HA

ND

YPER

SON

(2

yea

rs m

inim

um

exp

erie

nce

)D

YA

E

HA

RDW

ARE

/BU

ILD

ING

SU

PPLI

ES

– A

dm

in,

cler

ical

,

Man

agem

ent

only

AA

A

HO

ME

DU

TIES

/HO

ME

MA

KER

NA

AA

HO

RSE

RID

ING

INST

RUC

TOR

CY

AN

A

HO

RSE

STRA

PPER

DY

AD

HO

RSE

TRA

INER

/BRE

EDER

CY

AC

HO

RTIC

ULT

URI

ST

(Qu

alifi

ed –

min

imal

man

ual

)B

AB

HO

SPIT

AL

Aid

es

Dom

estic

O

rder

ly/W

ard

per

son

Re

gist

rar/

Man

ager

CY

CY

CY A

A

A

A

A

C

C

C

A

HO

TEL

IND

UST

RY (

incl

ud

ing

M

otel

s)

Man

ager

/Pro

prie

tor

– 10

or

mor

e fu

ll-tim

e em

plo

yees

–

un

der

10

full-

time

emp

loye

es

Staf

f –

Bar

– Bo

ttle

Shop

Atte

nd

ant

B

C CY C

A

A A

A

A

B C

C

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

– Bo

un

cer

– C

hef

–

Cle

aner

–

Driv

eway

Atte

nd

ant

– O

ffice

/Ad

min

on

ly

– W

aite

r –

Oth

er

NA

C

C

Y C

A

B

IC

A

A

A

A

A

A

A

NA

C

C

C

A

B

IC

HO

USE

PERS

ON

NA

AA

HU

MA

N R

ESO

URC

ES/

PERS

ON

NEL

MA

NA

GER

AA

A

IMPO

RTER

/EXP

ORT

ER (

offic

e on

ly)

AA

A

IND

UST

RIA

L C

HEM

IST

(non

h

azar

dou

s m

ater

ials)

AA

AA

INSP

ECTO

R –

Elec

tric

al

– M

eat

C

B

A

A

C

B

INST

RUM

ENT

MA

KER

BA

B

INSU

LATI

ON

INST

ALL

ERD

AC

INSU

RAN

CE

A

dju

ster

/Ass

esso

r (n

ot P

rivat

e In

vest

igat

or)

Ag

ent/

Sale

sper

son

Br

oker

In

spec

tor

B A

A

B

A A

A

A

B A

A

B

INTE

RIO

R D

ECO

RATO

R/D

ESIG

NER

(se

e D

ECO

RATO

R/D

ESIG

NER

)

INV

ESTI

GAT

OR/

INQ

UIR

Y A

GEN

TN

AA

NA

80


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

INV

ESTM

ENT

AD

VIS

OR

(Lic

ense

d)

AA

A

JAC

KARO

O/J

ILLA

ROO

/ ST

OC

KHA

ND

/STA

TIO

NH

AN

DD

YA

NA

JAN

ITO

RC

YA

C

JEW

ELLE

R Re

pai

rs/R

etai

l Sal

es

Oth

ers

(incl

ud

ing

Cu

tter/

Polis

her

/Se

tter/

Eng

rave

r)

B B

A A

B B

JOC

KEY

NA

EXC

or

BN

A

JOU

RNA

LIST

Fr

eela

nce

Sa

larie

d, n

o ov

erse

as a

ssig

nm

ents

IC

A

A

A

IC

A

KEN

NEL

PRO

PRIE

TOR

CA

C

KEY

PUN

CH

OPE

RATO

RB

AB

KITC

HEN

HA

ND

2

year

s ex

per

ien

ce

< 2

year

s ex

per

ien

ce

D

DY

A

A

KNIT

TER

(IN M

ILL)

CY

AC

LABO

RATO

RY T

ECH

NIC

IAN

(n

ot h

and

ling

rad

ioac

tive

or t

oxic

su

bsta

nce

s or

ch

emic

als)

O

ther

B

IC

A

IC

B

IC

LABO

URE

R (n

ot u

nd

er s

pec

ified

in

du

stry

)D

YA

E

LAN

D B

ROKE

RA

AA

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

LAN

DSC

APE

GA

RDEN

ER

Not

Qu

alifi

ed (

2 ye

ars

exp

erie

nce

) Q

ual

ified

(h

ortic

ultu

ral d

egre

e/d

iplo

ma

and

min

imu

m o

f m

anu

al la

bou

r)

Oth

er

C C

CY

A A

A

C B

C

LAW

N M

OW

ER S

ALE

S A

ND

SE

RVIC

EC

AB

LAW

NM

OW

ING

CO

NTR

AC

TOR

3

year

s ex

per

ien

ce

Oth

er

C

CY

A

A

C

C

LAW

YER

AA

AA

LIBR

ARI

AN

AA

A

LIFT

MEC

HA

NIC

CA

C

LIN

ES IN

STA

LLER

OR

LIN

ES

REPA

IRER

(se

e EL

ECTR

ICA

L or

TE

LEC

OM

MU

NIC

ATIO

NS)

LIN

OTY

PE O

PERA

TOR

CA

C

LIV

ESTO

CK

BUYE

R/D

EALE

RB

AB

LOC

KSM

ITH

BA

B

LOG

GIN

G (

see

TIM

BER)

LOSS

AD

JUST

ER (

not

Priv

ate

inve

stig

ator

/rep

osse

ssio

n)

BA

B

MA

CH

INER

Y EQ

UIP

MEN

T H

IRE

OR

SERV

ICE

CA

B

81

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

MA

CH

INIS

T C

loth

ing

–

in s

hop

or

fact

ory

away

fro

m h

ome

–

at h

ome

Met

al/W

ood

C

NA

D

Y

A

A

A

C

NA

D

MA

IL C

ON

TRA

CTO

R –

Van

–

Mot

orcy

cle

C

CY

A

A

C

C

MA

NA

GEM

ENT

CO

NSU

LTA

NT

AA

A

MA

NA

GER

D

irect

or –

Offi

ce D

utie

s O

nly

A

AA

MA

NIC

URI

ST

Not

wor

kin

g a

t h

ome

Wor

kin

g a

t h

ome

C

NA

A

A

C

NA

MA

NU

FAC

TURE

R O

ffice

du

ties

only

O

ther

(n

ot h

and

ling

tox

ic/

haz

ard

ous

subs

tan

ces)

A

IC

A

A

A

IC

MA

RKET

GA

RDEN

ERC

AB

MA

RITI

ME

(see

SH

IPPI

NG

/M

ARI

TIM

E IN

DU

STRY

)

MA

SON

DA

D

MA

SSEU

R/M

ASS

EUSE

NA

AN

A

MAT

HEM

ATIC

IAN

AA

AA

MEA

T PA

CKE

RD

YA

D

MEC

HA

NIC

(Q

ual

ified

)C

AC

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

MED

ICA

L PR

AC

TITI

ON

ERM

PA

A

MER

CH

AN

T BA

NKE

RA

AA

A

MER

CH

AN

T SE

AM

AN

NA

AN

A

MET

AL

IND

UST

RY

Fitte

r an

d T

urn

er (

Qu

alifi

ed)

Met

al S

up

ply

/Sto

cks

Shee

t M

etal

Wor

ker

Skill

ed S

up

ervi

sor

Oth

er W

orke

rs

C

DY D

C

DY

A

A

A

A

A

C

D

D

C

E

MET

ALL

URG

IST

Offi

ce/L

abor

ator

y on

ly

Fiel

d w

ork

M

eter

Rea

der

A

C

D

A

A

A

A

C

D

MIL

K BA

R Pr

oprie

tor

Emp

loye

e

B

B

A

A

B

B

MIL

K V

END

OR

CA

C

MIN

E W

ORK

ER

– A

dm

inist

ratio

n (

see

nex

t p

age)

–

Har

d R

ock

– So

ft Ro

ck O

pen

cut (

no e

xplo

sives

) –

Soft

Rock

Op

en c

ut

(exp

losiv

es

use

– ex

clus

ion

to a

pply

) –

Soft

Rock

Un

der

gro

un

d

(no

exp

losiv

es)

– So

ft Ro

ck U

nder

gro

und

(exp

losiv

es u

se –

exc

lusio

n to

app

ly)

– Pr

ofes

sion

al (

see

nex

t p

age)

–

Trad

esp

erso

n (

rate

acc

ord

ing

to

h

ard

or

soft

rock

abo

ve)

C

C C DY NA

A

A A A A

C

C NA

C NA

82


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

MIN

E W

ORK

ER –

PR

OFE

SSIO

NA

L (D

EGRE

E)

AN

D O

FFIC

E W

ORK

ER

– A

bove

gro

un

d (

rate

fo

r o

ccu

pat

ion

) –

Un

der

gro

un

d (

rate

as

MIN

E W

ORK

ER –

har

d o

r so

ft ro

ck)

MIN

E W

ORK

ER –

TR

AD

ESPE

RSO

N (

QU

ALI

FIED

) –

Rate

as

MIN

E W

ORK

ER

(har

d o

r so

ft ro

ck)

MIN

ISTE

R O

F RE

LIG

ION

(s

ole

occu

pat

ion

)A

AA

MO

DEL

NA

AN

A

MO

TEL

(see

HO

TEL

IND

UST

RY)

MO

TOR

VEH

ICLE

IND

UST

RY

Ass

embl

y/Pr

odu

ctio

n li

ne

wor

ker

Dea

ler

Det

aile

r M

ech

anic

Sa

les

Wre

cker

CY A

C

C

A

DY

A

A

A

A

A

A

C

A

C

C

A E

MU

SIC

IAN

O

rch

estr

al (

full-

time)

Te

ach

er (

full-

time)

not

wor

kin

g

at h

ome

Oth

er

IC

B NA

A

A A

IC

B NA

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

NAT

URO

PATH

G

ovt.

reg

ister

ed,

not

wor

kin

g a

t h

ome

Oth

er

A NA

A A

A NA

NAV

Y PE

RSO

NN

ELN

AA

NA

NEW

SAG

ENT

(Sal

es o

nly

)B

AB

NU

RSE

Aid

e D

enta

l G

ener

al

– En

rolle

d

– Re

gist

ered

G

eria

tric

Pe

rson

al c

are

atte

nd

ant

– H

osp

ital a

nd

Ag

ed c

are

faci

lity

base

d o

nly

–

In-h

ome

base

d

Mid

wife

Ps

ych

iatr

ic

Prim

arily

en

gag

ed in

ad

min

istra

tion

(eg

nu

rse

edu

cato

r, d

irect

or o

f nu

rsin

g)

Vete

rinar

y

CY B C

C

C DY

NA

C

C

C

C

A

A A

A

A A

A

A

A A

A

C

B C

C

D D

D

B

D A

C

NU

RSER

Y (P

LAN

TS)

CA

C

OC

CU

PATI

ON

AL

THER

API

ST

– w

ith d

egre

eA

AA

83

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

OIL

, PE

TRO

LEU

M A

ND

NAT

URA

L G

AS

IND

UST

RIES

D

istrib

uto

rs (

no

del

iver

y w

ork

invo

lved

) D

rille

r –

Offs

hor

e –

Oth

er (

no

exp

losiv

es)

– O

ther

(ex

plo

sives

) M

anag

emen

t, C

leric

al,

On

shor

e Re

finer

y (n

o rig

gin

g in

volv

ed)

– sk

illed

–

un

skill

ed

Pip

elin

e (s

urf

ace

wor

k on

ly)

– sk

illed

–

un

skill

ed

Rig

Per

son

nel

Ta

nke

r D

river

–

Loca

l –

Lon

g D

istan

ce

Wor

kin

g w

ith e

xplo

sives

, d

rillin

g

rigs,

un

der

gro

un

d w

ork

or d

ivin

g

B NA

D

Y N

A

A C

DY CY

DY

NA

D

DY NA

A A

A

A

A A

A A

A

A A

A

EXC

or

C

C NA

D

N

A

A B

C D

E NA

C

D N

A

OPH

THA

LMO

LOG

IST

(Qu

alifi

ed)

AA

AA

OPT

ICIA

NA

AA

OPT

OM

ETRI

STM

PA

A

ORC

HA

RDIS

TC

AC

ORT

HO

DO

NTI

STA

AA

A

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

OST

EOPA

TH

– Re

gist

ered

with

Ost

eop

ath

/C

hiro

pra

ctor

’s bo

ard

–

Not

reg

ister

ed w

ith O

steo

pat

h/

Ch

irop

ract

or’s

boar

d

B IC

A A

A IC

OW

NER

/DRI

VER

(se

e D

RIV

ER fo

r p

artic

ula

r ca

teg

ory)

OYS

TER

FARM

ERC

AC

PAIN

TER

Up

to

10 m

etre

s h

igh

O

ver

10 m

etre

s h

igh

C

DY

A

A

C

NA

PAIN

TER

(with

out

qual

ifica

tion

) U

p t

o 10

met

res

hig

h

Ove

r 10

met

res

hig

h

DY

NA

A

A

E NA

PAN

EL B

EATE

R (Q

ual

ified

)D

AC

PARK

ING

STA

TIO

N A

TTEN

DA

NT

BYA

B

PAST

RY C

OO

KC

AC

PATH

OLO

GIS

TM

PA

A

PATH

OLO

GY

AN

ALY

STA

AA

PATT

ERN

MA

KER

(fo

un

dry

mou

lds

etc)

DA

D

PAV

ERN

AA

NA

PAYR

OLL

GU

ARD

(se

e SE

CU

RITY

G

UA

RD)

PERS

ON

AL

TRA

INER

NA

AN

A

84


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

PEST

CO

NTR

OLL

ER/

EXTE

RMIN

ATO

RD

YC

NA

PHA

RMA

CIS

TA

AA

A

PHO

TOEN

GRA

VER

C

AC

PHO

TOG

RAPH

ER (

Loca

l) M

ain

ly s

tud

io

Aer

ial

Oth

er

B

NA

IC

A

A

A

B

NA

IC

PHYS

ICIS

TA

AA

A

PHYS

IOTH

ERA

PIST

CA

A

PIA

NO

TU

NER

BA

B

PIC

TURE

FRA

MER

CA

C

PILO

TN

AA

NA

PLA

STER

ERN

AA

D

PLU

MBE

R/G

AS

FITT

ERD

AC

PLU

MBE

R (R

oof)

DY

AE

POD

IATR

IST/

CH

IRO

POD

IST

–

Reg

ister

ed w

ith P

odia

trist

’s re

gist

ratio

n b

oard

–

Not

reg

ister

ed w

ith P

odia

trist

’s re

gist

ratio

n b

oard

A IC

A A

A IC

POLI

CE

Mot

orcy

clist

N

on M

otor

cycl

ist

NA

NA

EX

C o

r C

A

NA

E

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

POST

OFF

ICE

Au

stra

lia P

ost

Shop

Em

plo

yee

Post

Offi

ce A

gen

t (s

ole

busin

ess)

D

eliv

ery

Van

M

ail S

orte

r M

otor

cycl

e

B

B

C

C

CY

A

A

A

A

A

B

B

C

C

C

PRIN

TER/

PUBL

ISH

ER

No

Man

ual

Wor

k Sk

illed

Man

ual

Wor

k

(eg

En

gra

ver/

Lin

otyp

e op

erat

or)

Oth

er W

orke

r

A

B IC

A

A A

A

B IC

PRIS

ON

OFF

ICER

NA

AN

A

PRIV

ATE

DET

ECTI

VE/

INV

ESTI

GAT

OR

NA

AN

A

PRO

CES

S/PR

OD

UC

TIO

N W

ORK

ERC

YA

C

PRO

DU

CE

MER

CH

AN

TC

AC

PRO

FESS

ION

AL

SPO

RTS

PERS

ON

NA

AN

A

PRO

GRA

MM

ER (

see

CO

MPU

TER

IND

UST

RY)

PRO

PERT

Y C

onsu

ltan

t In

vest

or

Dev

elop

er

A

NA

IC

A

A

A

A

NA

A

PSYC

HIA

TRIS

TM

PA

A

PSYC

HO

LOG

IST

MP

AA

PUBL

IC R

ELAT

ION

S O

FFIC

ER

(Ter

tiary

Qu

alifi

ed)

AA

A

85

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

PUBL

IC S

ERV

AN

TS –

CLE

RIC

AL

AA

A

PUBL

ISH

ER (

see

PRIN

TER)

PURC

HA

SIN

G O

FFIC

ER

– C

leric

al

– O

ther

A

ICA

A

A

B

QU

AN

TITY

SU

RVEY

OR

AA

A

QU

ARR

Y W

ORK

ERD

YEX

C o

r C

NA

RAD

IO/T

ELEV

ISIO

N/F

ILM

IN

DU

STRY

A

ctor

A

dm

inist

ratio

n

An

nou

nce

r C

amer

a O

per

ator

–

Stu

dio

On

ly

– O

n L

ocat

ion

(n

o ov

erse

as

wor

k)

– O

ther

D

irect

or/P

rod

uce

r Ed

itor

Eng

inee

r Pr

ojec

tion

ist

Rep

orte

r (n

o ov

erse

as w

ork,

not

fre

elan

ce b

ased

) TV

/Rad

io T

ech

nic

ian

/Rep

aire

r

NA

A

BY

B

C IC

A

A

B

B

A B

A

A

A A

A A

A

A

A

A

A A

NA

A

N

A

B

C IC

A

A

B

B

A B

RAD

IOG

RAPH

ERA

AA

RAD

IOLO

GIS

TA

AA

A

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

RAIL

WAY

WO

RKER

D

river

Fi

rep

erso

n

Gu

ard

In

spec

tor

(tick

et o

nly

) La

bou

rer

Mai

nte

nan

ce

Port

er

Shu

nte

r Si

gn

al p

erso

n

Stat

ion

Mas

ter

Stat

ion

Ass

istan

t Ti

cket

Col

lect

or

Trac

k La

yin

g

DY

DY

CY B

DY

DY

DY

DY

BY

BY

CY B

DY

A

EXC

or

C

A

A

A

A

A

A

A

A

A

A

A

C

NA

B

B

E E D

NA

B

B

B

B

N

A

REA

L ES

TATE

AG

ENT

AA

A

REA

L ES

TATE

AU

CTI

ON

EER

(3

yrs

exp

)A

AA

REC

EPTI

ON

IST

(offi

ce d

utie

s on

ly)

AA

A

REFR

IGER

ATIO

N M

ECH

AN

IC/

REPA

IRER

BA

C

REM

OV

ALI

ST

Loca

l Lo

ng

Dist

ance

DY

NA

A

A

D

E

REPA

IRER

/SER

VIC

E TE

CH

NIC

IAN

Li

ght

Man

ual (

eg O

ffice

Mac

hine

s)

Hea

vy M

anu

al

B

C

A

A

B

C

REPO

RTER

(se

e JO

URN

ALI

SM)

86


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

REST

AU

RAN

T C

hef

/Coo

k

Prop

rieto

r/M

anag

er

– 5

or m

ore

emp

loye

es

– le

ss t

han

5 e

mp

loye

es

Wai

ter

Oth

er fu

ll-tim

e em

plo

yees

C B

C

B

IC

A A

A

A

A

C A

B

B

IC

RIG

GER

NA

AN

A

ROO

FER/

ROO

F TI

LER

DY

AE

RUBB

ISH

REM

OV

ALI

ST

DY

AD

SALE

S RE

PRES

ENTA

TIV

E

(see

also

AG

ENT,

CA

R SA

LESP

ERSO

N,

SHO

P PR

OPR

IETO

R/A

SSIS

TAN

T)

Not

list

ed e

lsew

her

e (n

o d

eliv

ery/

asse

mbl

y/re

pai

r)

Oth

er

A

IC

A

A

A

C

SAN

D B

LAST

ERD

YA

NA

SCA

FFO

LDER

DY

AN

A

SCRA

P M

ETA

L D

EALE

RD

YA

D

SEA

MA

NN

AA

NA

SEA

RCH

/RES

CU

E W

ORK

ER

(not

vol

un

teer

)N

AA

NA

SEA

SON

AL

WO

RKER

SN

AIC

NA

SEC

ON

D H

AN

D D

EALE

RB

AB

SEC

RETA

RY/S

TEN

OG

RAPH

ER

(not

full-

time

keyb

oard

)A

AA

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

SEC

URI

TY G

UA

RD

Arm

ed

Un

arm

ed (

no

un

usu

al h

azar

ds)

DY D

A

A

NA

N

A

SERV

ICES

(A

RMED

FO

RCES

)N

AA

NA

SERV

ICE

STAT

ION

/GA

RAG

E A

tten

dan

t/W

orke

r C

onso

le O

per

ator

(n

o d

rivew

ay

wor

k)

Mec

han

ic (

qual

ified

) Pr

oprie

tor

(no

mec

han

ical

wor

k)

CY

BY

C

B

A

A A

A

C

B C

B

SHEA

RER/

SHEA

RIN

G

CO

NTR

AC

TOR

DY

AN

A

SHEE

T M

ETA

L W

ORK

ERD

AD

SHIP

PIN

G/M

ARI

TIM

E IN

DU

STRY

Se

agoi

ng

Per

son

nel

–

Cre

w

– O

ffice

r –

Eng

inee

r Sh

ore

Pers

onn

el

– A

dm

inist

ratio

n o

nly

–

Doc

k w

orke

r –

Ship

yard

wor

ker

NA

N

A

NA

A

NA

D

Y

A

A

A A

A

A

NA

B

C

A

NA

N

A

SHIP

WRI

GH

TC

AC

SHO

E M

AKE

R/RE

PAIR

ERC

AC

SHO

P FI

TTER

CA

C

87

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

SHO

P PR

OPR

IETO

R/A

SSIS

TAN

T A

ntiq

ues

(Sa

les)

A

ntiq

ues

(Re

stor

atio

n)

Bicy

cles

Bo

okse

llers

, St

atio

ner

y, C

ard

s Br

ead

/Cak

es (

no

baki

ng

) Bu

tch

er (

reta

il –

no

slau

gh

terin

g)

Caf

é C

hin

a/G

lass

war

e C

loth

ing

C

urt

ain

(sa

les

only

) D

elic

ates

sen

D

ispos

als

Dry

Cle

aner

–

Prop

rieto

r/M

anag

er

– O

ther

El

ectr

ical

, Ra

dio

, Te

levi

sion

(sa

les

only

) Fa

st F

ood

Fi

shm

ong

er (

not

fish

an

d c

hip

sh

op)

Flor

ist

Fru

itere

r an

d G

reen

gro

cer

Furn

iture

(n

ew r

etai

l) Fu

rrie

r G

ener

al S

tore

G

ift

Gla

ss (

pla

te g

lass

etc

) G

un

smith

H

aber

das

her

, D

rap

er

B

C

B

B

B

C

B

B

B

B

B

B C

D

B C

C B

C

B

B

B

B

B

B

B

A

A

A

A

A

A

A

A

A

A

A

A A

A

A A

A A

A

A

A

A

A

A

A

A

B

C

B

B

B

C

B

B

B

B

B

B C

D

B C

C B

C

B

B

B

B

B

B

B

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

SHO

P PR

OPR

IETO

R

Har

dw

are

(Lig

ht

liftin

g)

Hea

lth F

ood

s Je

wel

ler

(reta

il on

ly)

Law

nm

owin

g (

Sale

s an

d s

ervi

ce)

Lice

nse

d G

roce

r/Li

quor

Sto

re

Lin

ger

ie

Lock

smith

M

ilk B

ar

Mill

iner

(re

tail

only

) M

obile

(eg

ice

crea

m,

don

uts

) M

otor

Sp

ares

M

usic

/Mu

sical

Inst

rum

ents

N

ewsa

gen

t (S

ales

on

ly)

Phot

ogra

ph

ic (

mai

nly

STU

DIO

) Se

con

dh

and

Sh

oe S

tore

(Sa

les

only

) Sk

in/H

ide/

Leat

her

Sp

ortin

g G

ood

s (s

ales

on

ly)

Sup

erm

arke

t Pr

oprie

tor

– M

anag

er L

arg

e St

ore

– O

ther

To

bacc

onist

(n

o h

aird

ress

ing

) V

ideo

Sh

op

Not

Oth

erw

ise R

ated

–

Lig

ht

goo

ds

only

(eg

clo

thes

) –

Hea

vy g

ood

s (e

g m

ach

iner

y)

– M

ain

ly t

ake-

away

food

C

B

B

C

B

B

B

B

B

CY B

B

B

B

B

B

B

B B

C

B

B B

C

C

A

A

A

A

A

A

A

A

A

A

A

A

A

A

A

A

A

A A

A

A

A A

A

A

C

B

B

B

B

B

B

B

B

C

B

B

B

B

B

B

B

B B

C

B

B B

B

B

SIG

N E

REC

TOR

DY

AN

A

SIG

N W

RITE

RC

AB

88


Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

SLA

UG

HTE

RER

NA

AN

A

SOC

IAL

WO

RKER

BA

B

SOFT

DRI

NK

MA

NU

FAC

TURE

RC

AC

SOLI

CIT

OR

AA

AA

SPEC

IALI

ST P

HYS

ICIA

NA

AA

A

SPEE

CH

TH

ERA

PIST

(Q

ual

ified

)A

AA

SPO

RTIN

G/F

ITN

ESS

CLU

B

– M

anag

emen

t/A

dm

in.

only

–

Coa

ch

– O

ther

s –

Gym

Inst

ruct

or

– Pe

rson

al T

rain

er

A

IC

IC

NA

N

A

A

A

A

A

A

A

IC

IC

NA

N

A

SPRA

Y PA

INTE

R (Q

ual

ified

)C

AC

SQU

ASH

CO

URT

PRO

PRIE

TOR

(full-

time

only

, n

on p

rofe

ssio

nal

p

layi

ng

)B

AB

STAT

ISTI

CIA

NA

AA

A

STEE

L ER

ECTO

R/FI

XER

DY

AN

A

STEV

EDO

REN

AA

NA

STO

CKM

AN

/STA

TIO

N H

AN

D (

see

JAC

KARO

O)

STO

NEM

ASO

ND

AD

STO

REKE

EPER

(se

e SH

OPS

)

STO

REPE

RSO

N (

ligh

t m

anu

al)

CA

C

STO

REPE

RSO

N A

ND

PA

CKE

RD

AC

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

STU

DEN

TN

AA

IC

STU

NTP

ERSO

NN

AIC

NA

SURG

EON

AA

AA

SURV

EYO

R

Exp

losiv

es

Oth

er

DY B

SP

C o

r C

A

NA

B

SWIM

MIN

G P

OO

L Bu

ilder

Pr

oprie

tor/

Man

ager

Sw

imm

ing

Inst

ruct

or (

full-

time

only

, n

ot s

easo

nal

) A

tten

dan

t

C

B

IC N

A

A

A

A A

C

B

IC N

A

SYST

EMS

AN

ALY

ST (

see

CO

MPU

TER

IND

UST

RY)

TAB

(TO

TALI

SATO

R) A

GEN

T

(full-

time

only

)B

AB

TAKE

-AW

AY F

OO

D S

HO

P PR

OPR

IETO

R (3

yea

rs e

xper

ien

ce)

CA

C

TAIL

OR

(not

wor

kin

g fr

om h

ome)

CA

C

TAN

NER

DA

NA

TAX

CO

NSU

LTA

NT

AA

A

TAXI

DRI

VER

CY

AC

89

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

TEA

CH

ER

Mu

sic (

full-

time)

Ph

ysic

al (

eg p

hys

ical

ed

uca

tion

, d

anci

ng

) Tr

ade

(eg

ag

ricu

lture

, Te

chn

ical

co

lleg

e)

Oth

er

B

C C A

A

A A A

B

NA

C A

TELE

CO

MM

UN

ICAT

ION

S/TE

LEPH

ON

E/TV

En

gin

eer

– D

egre

e, O

ffice

Du

ties

On

ly

Eng

inee

r (N

ot Q

ual

ified

) Li

nes

Inst

alle

r or

Lin

e Re

pai

rer

– To

wer

–

Oth

ers

AA

B DY

DY

A A A

A

A B NA

N

A

TELE

PHO

NIS

T/SW

ITC

HBO

ARD

O

PERA

TOR

AA

A

TELE

VIS

ION

(se

e RA

DIO

/TE

LEV

ISIO

N/F

ILM

IND

UST

RY)

TEN

NIS

CO

AC

H (

3 ye

ars

exp

erie

nce

, fu

ll-tim

e on

ly,

not

to

urin

g o

r p

rofe

ssio

nal

pla

yer)

CA

NA

TEXT

ILE

WO

RKER

SC

YA

C

Occ

upat

ion

Inc.

Pr

ot

Trau

ma

&

AD

L TP

D

TPD

THEA

TRE/

CIN

EMA

IND

UST

RY

(full-

time

only

) A

ctor

D

irect

or/P

rod

uce

r M

anag

emen

t

(Ad

min

istra

tion

on

ly)

Mak

e-u

p

Proj

ectio

nist

Ti

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91

Pursuits and pastimesAdviser Easy Reference Guide to Insurance

This section of the guide covers a variety of popular pursuits and pastimes.

Some activities present an extra risk and it may be necessary to impose an extra premium or an exclusion clause.

The following table lists a number of activities and provides an indication of possible extra premiums or exclusions. The table is a guide only and each application will be individually underwritten on the specific information provided. The Underwriter may choose to apply an exclusion or loading in an individual situation even if not indicated in the table. If you have any questions, please call the underwriting team.

Legend

Assessments

Std Standard rates will usually apply

$2.00 $2.00 extra premium per thousand of the sum insured




E Cover may be offered with a full exclusion clause for the pursuit

IC Individual consideration

WP Waiting period

D Cover will be declined

Min Minimum extra premium

92

Pursuit/Pastime Life Trauma TPD IP/BE

Aviation (Agriculture) Min $10.00 D D D

Aviation (Private licence) – not ultralight, not hazardous – up to 100 hours per annum Std Std Std Std – over 100 hour per annum IC IC D E

Aviation (Commercial licence) – up to 250 hours per annum Std Std D D – over 250 hours per annum IC Std D D

Aviation (Hazardous) – for example, aerobatics IC IC IC IC

Aviation (Ultralight) Min $5.00 E E E

Boxing Amateur Std E IC IC

Boxing Professional Min $3.50 D D D

Diving (recreational) no caving, potholing or Std Std Std Std wreck diving < 40 metres

Diving – qualified (recreational) no caving, potholing E E E E or wreck diving > 40 metres

Football – (Touch) Std Std Std Std

Football – (All other codes) occupations Std Std Std 30 day MP, AA, A and B WP for football


93


Football – (All other codes) Std Std Std 90 day WP occupations C, D and F for football

Golf Std Std Std Std

Hockey Std Std Std Std

Horseriding (amateur only) Polo or show jumping Std Std-E E E

Horseriding (amateur only) Trail riding, dressage Std Std Std Std

Horseriding (amateur only) Rodeo Std E E E

Martial Arts (non-competitive) Std Std Std Std

Motor Cycle Racing (amateur only) IC IC E E

Motor Car Racing (amateur) IC IC E E

Motor Cycle Riding (road use only) under age 25 Std Std E E

Motor Cycle Riding (road use only) Std Std Std 30 day WP occupations MP, AA, A and B age 25 and above for motor cycle riding

Motor Cycle Riding (road use only) occupations Std Std Std 90 day WP occupations C, D and F age 25 and above for motor cycle riding

Mountaineering (including abseiling, Min $2.00 E E E outdoor rock climbing)

94


Sailing Australian coastal water Std Std Std Std

Sailing Otherwise IC E E E

Snow skiing Recreational Std Std Std Std

Snow skiing Competitive Std Std E E

Snow Skiing Professional Std Std D D

Trail bike riding Recreational Std Std E E

Trail bike riding Competitive Std Std IC IC

Water skiing Recreational Std Std Std Std

Water skiing Competitive Std Std E E

Wrestling Amateur Std Std E E

Wrestling Professional Std Std D D


95

Claims requirementsAdviser Easy Reference Guide to Insurance

Claims philosophyWe have a duty to all our policyholders and stakeholders to thoroughly evaluate each claim based on the terms and conditions of the contract and the information provided and disclosed at the time of purchase and claim(s).

It is our business to pay genuine claims that satisfy a reasonable interpretation of the terms and conditions of the relevant policy. We strive for fair, ethical and transparent service to our clients and their advisers.

Each claim will be assessed fairly and sensibly, based on medical and other relevant evidence using consistent guidelines and procedures and according to policy terms and conditions.

Claims that meet the policy terms and conditions will be paid promptly when all necessary information has been received and assessed.

We understand this is a time of physical, social and financial distress for the client or their beneficiaries and when they need us most.

We will:

deal with our claimants with compassion and empathy;•case manage each claim using best-practice claims management techniques;•maintain regular contact with our clients, as appropriate, either by phone, letter, •facsimile or in person;

make sure claims matters are dealt with efficiently and promptly and with utmost •good faith;

aim to keep advisers fully informed, as appropriate, throughout the course •of a claim; and

comply with legislation affecting claims management.•

To help accelerate the claims management process, the client is asked to:

complete forms and documents requested;•promptly provide all information requested; and•ensure that full and frank details are provided.•

Income Protection claims will be pro-actively managed. We will work with your client, their doctors and rehabilitation providers to help your client return to good health and work.

While we recognise that both parties to the claim must act toward each other in good faith, we are committed to protecting AXA. To this end, we make our best efforts to minimise payment of fraudulent and illegitimate claims.

During the life of a claim the insurer has a reasonable expectation of the insured to mitigate his or her loss. Where possible, we would expect the client to make a reasonable attempt toward vocational rehabilitation and a return to the workforce.

96

ComplianceAs you are aware, we may make a number of requests for requirements. The Client may need to attend independent medical examinations in order to obtain objective specialist opinions in regards to the claimed disability.

Medical reports will be requested from treating doctors regarding the disability, and past medical histories may be obtained to verify statements made on their application.

Financial information may also be requested in order to verify the Client’s pre-disablement income, pre-policy inception income, and/or to confirm that no income has been received/generated by personal exertion during a claim for total disablement.

We are committed to providing excellence in customer service, which includes making reasonable requests of clients where necessary during the claims process.

In some instances, assessment of a claim may be delayed where a reasonable request has not been complied with. We encourage contact between the client, the claims assessor and or their financial adviser to address any concerns of issues that may arise out of any requests made by us.

Hypothetical enquiries While we are always committed to providing customer service, the helpfulness of providing answers to hypothetical queries is limited given the potential variables in an actual situation.

Where possible we will provide a general answer to the query, however, as the assessment of claims involves evaluation of the actual circumstances and the terms and conditions of the relevant contract, no reliance can be placed on the answers given in the context of hypothetical situations.

It is worth considering whether or not your Business Development Officer (BDO) or Business Development Manager (BDM) would be appropriate to contact to initially discuss the query.

Notification of claimsPlease call us, fax or write to us to notify us of an actual or potential claim. A phone call helps us start the claim process as quickly as possible. Please call our customer service centre on 132 987.

TIP – always make sure you have your client’s policy number(s) handy when contacting us about your client’s claim(s). This will help us locate your client’s records quickly and provide speedy service to you.


97

Death claims

Please ensure that the following details are provided to us at time of notification:

policy number(s);•full name of claimant/life insured;•date of death;•cause of death (if known); and•name and address for correspondence.•

All other claims

Please ensure that the following details are provided to us at time of notification:

policy number(s);•full name of policy owner;•full name of claimant/life insured;•nature of claim; and•name and address for correspondence.•

Terminal illness

Please call or write to us as soon as possible after the person insured is diagnosed with a terminal condition. We will send claim forms to the address advised for correspondence.

Income Protection

In accordance with our policy we must be told within 30 days of the accident, operation or illness that a claim is to be made. We request that all notifications of Income Protection claims are made as soon as possible after the initial injury or procedure or after onset of sickness.

Not to do so may prejudice our ability to assess the claim or make rehabilitation assistance available, which may in turn result in denial of benefits (at worst) or otherwise cause avoidable processing delays.

Assessment of claims

Death claims

The requirements for a claim for death benefits vary greatly, depending on the form of insurance, policy ownership and sum insured. All copies of information provided must be certified genuine that is, we require original certification of the copies of the original documents.

Minimum requirements are:

Certified copy of the final Death certificate*;•Proof of age that is, certified copy of birth certificate•

98

Will/Probate/Letters of Administration may be required in some circumstances; and•Coroner’s or if available a Police Report will be required where the cause of death is •not specified or is undetermined.

* Tasmania does not issue death certificates, instead providing a Record of Death. This does not advise the cause of death. Before we can assess a claim for death benefits from Tasmania, we require a copy of the Record of Death and either the “Medical Certificate Cause of Death” or a Coroner’s report.

For ordinary life plans we will also require:

The original policy document or a signed lost policy document form;•Application for Payment form signed by the appropriate parties.•Notice of Death Claim.•

For superannuation life plans we also require:

Dependency form completed by and “independent” person;•Tax file number(s)/declaration(s); and•Marriage certificate/Decree Nisi may be required, where applicable, in •some circumstances.

It is important to note that in certain circumstances the Trustees of the fund may require the granting of Probate or Letters of Administration to be made prior to making a determination to release any funds from the plan.

For ordinary business policies payable to the deceased’s estate, where there are no surviving policy owners or nominated beneficiaries, and the total sum insured for all plans with us does not exceed $50,000 we will require a “Notice of Death Claim” concerning the Will and any beneficiaries.

Where the sum insured exceeds $50,000 we require an originally certified copy of Probate or Letters of Administration. It is important to note that Probate or Letters of Administration are not required, regardless of the sum insured, where a valid beneficiary(ies) had been initially noted on the proposal or subsequently nominated or where ownership of the policy differs from that of the deceased.

We may require further medical evidence such as reports from the deceased’s treating doctors or a report from the Coroner or Police prior to being able to make a final assessment of the claim. If we require these documents medical authorities or questionnaires will be sent to the Executors or next-of-kin for signing and returning.

We will pay for any medical or allied evidence we request beyond costs involved in providing the certification of death.

Terminal illness claims

Completion of claim form

The claimant or their representative may complete the form. Please note we will require a copy of the power of attorney or similar if the client is unable to sign the forms themself.

Claims requirements Adviser Easy Reference Guide to Insurance

99

The client’s treating doctor is to complete the medical certification and forward it to us. Only registered medical practitioners, not allied health workers, may complete the certification. Certification from chiropractors, physiotherapists, naturopaths and other health professionals will not be accepted.

Please ensure we receive the completed forms as soon as possible. This will help us to be of assistance to your client.

When we have received the claim form, we check to ensure premiums have been paid and the policy was inforce at the time of claim.

We may ask for further information such as proof of age or authority to access medical or other records relevant to the claim or at the time of applying for insurance. To help us assess the claim, we may need:

further information from the client’s treating doctor(s); or •your client’s condition to be reviewed by one or more independent •medical practitioners.

We will pay for any medical evidence we request beyond the initial claim form.

Requests for medical evidence, particularly from treating doctors, may create delays in assessment of the claim. We follow up requests for reports from doctors regularly and make every attempt to expedite the process but we are dependent on the co-operation of the doctor.

TPD claims


The claimant or their representative may complete the form. The claim form includes medical authorities, a Freedom of Information authority and a Health Insurance Commission authority. All parts of the claim form must be completed to the best of the claimant’s ability.

Please note we will require a copy of the power of attorney or similar if the client is unable to sign the forms themself.

When we have received the claim forms, we check to ensure that premiums have been paid and the policy was inforce at the time of claim.

Should the authorities not be completed and provided with the initial claim form, delays will be met until these are provided. The authorities provide AXA with the ability to investigate the client’s medical and claims history as required.

To help us assess the claim, we will require further information from the client’s treating doctor(s). We may require the client to be assessed by independent medical practitioners. We will pay for any medical evidence we request.

100


Trauma claims


The claim form includes medical authorities and a statement of claim. The claimant or their representative may complete the form. All parts of the claim form must be completed to the best of the claimant’s ability.

Please note we will require a copy of the power of attorney or similar if the client is unable to sign the forms themself.

When we have received the claim form, we check to ensure that premiums have been paid and the policy was inforce at the time of claim.

If we do not receive completed authorities with the initial claim form, delays will be met until these are provided. The authorities provide AXA with the ability to investigate our client’s medical history as needed.

To help us assess the claim and confirm the client’s condition, we may need:

information from the client’s treating doctor(s); and•your client’s condition to be assessed by one or more independent •medical practitioners.

We will pay for any medical evidence we request.


The submission, with the Initial Claim Form, of any medical investigation reports such x-rays, pathology reports and ECGs may expedite the assessment of the claim.

Interim Cover claims

We provide interim insurance cover commencing from the date the client’s application form and first premium payment (or effective deduction authority for that amount), are received at our office. Please refer to the Product Disclosure Statement to confirm eligibility and duration of benefits for Interim Cover Insurance.

Requirements for initial assessment

For Income Protection Interim Cover claims we require a completed claim form and authorities from the client and their doctor to begin assessment of the claim. A medical


101

practitioner whose qualifications are recognised in Australia must complete the medical certificate section of the claim form. Any fee for completion of medical certification is the responsibility of the client. Medicare may cover part or all of the costs of medical certification. We regret that we cannot accept short medical certificates or worker’s compensation medical certification – all medical certification must be provided on our forms.

For Life Plans (Accidental Death) we require:

The relevant death claim requirements as for a completed policy;•Copy of the Coroner’s file and Police Report (if this is not already in the •Coroner’s Report).

For TPD Interim Cover claims we require a completed claim form and authorities from the client and their doctor to begin assessment of the claim. Any other information that the client may hold that would be relevant to the claim (eg Work Cover or Work Care paperwork) should also be submitted with the claim form to expedite proceedings.

All copies of information must be certified genuine.

When we have received the claim forms and any other requirements, we will check to ensure the Interim Cover for Accidental Death and Income Protection benefits was in place at the time of the illness or injury.

If we do not receive completed authorities with the initial claim (except for death claims), delays will occur until these are provided. The authorities provide us with the ability to investigate your client’s medical history as needed.

We may ask for further information to help us assess the claim.

We will pay for any medical evidence we request beyond those provided at time of initial claim. We will not pay for obtaining up to date Progress Claim forms.


Income Protection claims

Income Protection claims management is focused on customer service and assisting your claimant’s return not only to good health, but also to work.

Completion of initial claim form

We require completed claim forms from the client and their doctor to begin assessment of the claim. We cannot assess a claim until both the client’s statement and the doctor’s certification is received.

102

A medical practitioner who is registered and whose qualifications are recognised in Australia must complete the medical certificate section of the claim form. We cannot accept certification from a physiotherapist, chiropractor, naturopath or any other allied health professional.

Any fee for completion of medical certification is the responsibility of the client. Medicare may cover part or all of the costs of medical certification.

We regret that we cannot accept short medical certificates or worker’s compensation medical certification – all medical certification must be provided on AC&L/AXA forms.

Initial claims assessment

Assessment of a new claim begins when we have received, fully completed, the claim form from the client and their doctor. The form allows the case manager to identify whether we can admit the claim or whether we require further information.

Please note even though the client and their doctor have fully completed the claim form, we may need further information before we can admit liability for the claim. Typical examples include:

further details of the disability from the treating general practitioner, treating specialist •or independent specialist;

financial details (tax returns, etc);•details of Worker’s Compensation, Third Party or other disability insurance from •another insurer; and

medical history from the Health Insurance Commission or client’s treating doctors. •

We may also arrange for a representative to visit your client at home to gain a better understanding of the claimant’s circumstances.

Further medical information helps us to determine how long a client’s disability is likely to last and whether we can assist the client in their return to work. The client’s medical history can assist with this process and also confirms that the claimant has fully disclosed their medical history.

Useful terminology and information

Date of Loss – The Date of Loss is determined from the date the client ceases all work duties and is certified by a medical practitioner as unable to work.

Qualifying/Waiting Period – Most policy benefits have a waiting period. The waiting period starts from the Date of Loss and is the amount of time that must elapse before any benefit may be payable. It is important to note that benefits are not calculated retrospectively from the date of loss.


103

Financial requirements for Agreed Value Contracts

At the beginning of the agreed value contract, we rely on the client’s statement of income on the proposal to set the benefit entitlement (subject to underwriting guidelines – please see pages 46 and 47). Unless full, accurate and complete financial evidence was provided at underwriting it is necessary in many cases for us to request this information at claim stage. Financial evidence to support the income at the time of application will be required. We would encourage financial underwriting at application stage when the evidence may be more readily available and easy to locate.

Further financial information will be required as part of the claims process when assessing partial disability.

Financial requirements for Indemnity Contracts

During the course of the claims process, financial information may be requested from the Client. We may request Personal and Business (such as Company, Partnership and Trust) Tax Returns, Associated Profit & Loss Statements and Individual Tax Assessment Notices. In some instances we may also request Business Activity Statements.

This information is requested as it provides details of income and expenses that have been lodged with, and verified by the Australian Taxation Office.

The following scenarios may give rise to a request for financial accounts:

Indemnity Contracts: financial information would be requested where the policy definition states that we pay the lesser of the Monthly Benefit or 75% of Pre-Disability Earnings.

Pre-Disability Earnings are the Net Earnings (Gross Income less Gross Expenses but before Tax) the Insured earned prior to their disability.

Partial Disability: in the event that a Client returns to work part time, it is necessary to establish their Pre-Disability Earnings to enable the calculation of a Partial Benefit payment.

Further financial information will be required as part of the claims process when assessing partial disability.

In some instances, we may also request the Business Activity Statement of the Client to assess work activity.

Offsets: if the Client is receiving income from another Insurer, Workers’ Compensation or another sources, we may offset this income. In some cases we may need to establish the Client’s Pre-Disability Earnings in order to apply the relevant offset.

Benefit Reconciliation: the Client may be asked to provide their financial accounts to verify that they have accurately disclosed income from sources other than our benefits, whilst on claim.

In addition, while the Client is receiving income from other sources such as income while partially disabled, from Workers’ Compensation or another Insurer, financial accounts will

104

be requested to reconcile all benefits paid. That is, to ensure that we have paid the correct benefit amount.

Documents required for Financial Assessment

Full financial information is required from the claimant to ensure the correct benefit entitlement is paid.

For employees, this information consists of tax returns and, if applicable, details of salary packaging for the requested years.

For self-employed persons, we require copies of the claimant’s business structure and financial information as follows:

individual Income Tax Returns and assessment notices;•details of all business entities in which the client holds any interest or over which •he/she exercises any control by way of being a director, partner, principal, officer or trustee;

a diagram of the business structure; and•full financial statements for all business entities in which the claimant holds any •interest or over which the claimant exercises any control by way of being a director, partner, principal or officer etc, including the Trading Statement, Detailed Profit and Loss Statement, Balance Sheet, Accountant’s Notes to and Forming Part of the Accounts, Business Income Tax Return (Individual – in case of sole trader/Partnership/Company/Trust – whichever is applicable), Details of salaries paid to partners or directors and duties performed by spouse (to determine if there is any income splitting).

Income Tax Assessment Notices are of no use on their own as they provide only the lowest level that a person has been able to write down their income. They do not give a true indication of the client’s personal exertion income. They do however verify that the correct Income Tax Returns have been supplied. The accountant’s disclaimer and the notes to the accounts confirm that an accountant has drawn up financial statements.

Payment of claims

Death claim payments

We will make payment as soon as possible after all requirements are met and the claim has been assessed. Most claims are paid within two weeks of provision of all requirements.

Please note should the coroner’s findings be required, assessment of the claim can take some months thereby delaying any possible payment.

Before payment can be made under superannuation plans, the Trustee of the fund must approve the benefit payment and determine the beneficiaries of the payment.


105

Terminal Illness payments

We will make payment as soon as possible after all requirements are met and the claim has been assessed.

Before payment can be made under superannuation plans, the Trustee of the fund must approve the benefit payment. Payment is made to the Trustee. Where NM Superannuation Pty Ltd is the Trustee, payment is made to the client as directed by the Trustee based on legislative guidelines.

TPD payments

When the claim has been assessed, if payment is to be made for ordinary life plans we will require:

an application for payment;•a certified copy of the extract of birth or full birth certificate; and •the policy document or a lost policy document application. •

For superannuation life plans (excluding Group Insurance), we will require:

a dependency form; and•a tax file number/declaration.•

These details are not requested until the claim has been assessed and liability accepted, as we prefer to reduce the amount of paperwork required from the client. We cannot make payment until these details are received.

We will make payment by cheque as soon as possible after all requirements are received for a claim for which we have accepted liability.

Before payment can be made under superannuation plans, the Trustee of the fund must approve the benefit payment. Payment is made to the Trustee. Where NM Superannuation Pty Ltd is the Trustee, payment is made to the client as directed by the Trustee based on legislative guidelines.

Trauma payments

When a claim is accepted, before payment can be made, we will require:

a certified copy of the extract of birth entry for the insured;•an application for payment; and•the policy document or lost policy application.•

These details are not requested earlier in the process as it reduces paperwork required from the client in case the claim is declined.

We will make payment as soon as possible after we receive and assess all requirements for the claim. Most claims are paid within two weeks of receipt of all requirements.

106

Interim cover payments

We will make payment as soon as possible after all aspects of the claim have been assessed and satisfies a reasonable interpretation of the terms and conditions of interim insurance cover as specified within the relevant Product Disclosure Statement.

Following the claim

Please note that during a claim under Interim Cover insurance the application for insurance has yet to be underwritten. The application for insurance following a claim (whether the claim is accepted or not) will be referred to an Underwriter for assessment.

Income protection payments

Please note that we do not deduct tax from IP benefits. Therefore, all benefits received must be declared as assessable income in the person insured’s taxation return. Benefits for income protection are only paid while the person insured satisfies the appropriate definitions under the policy.

Claim payments

Partial disability payments are made on the basis of loss of income compared to pre-disability income where the decreased income is a result of illness or injury. Loss of income is proved by pay slips (for employees) or profit and loss statements for self-employed persons. We generally find it is more convenient for our clients to provide month by month profit and loss statements than fortnightly statements in support of their claim for partial disability benefits.

Business Expenses claims

These usually require the same forms used for assessing Income Protection claims. Additional requirements are completion of a Business Expenses Questionnaire. We may request the expenses listed on the questionnaire be supported by monthly profit and loss statements and request full financial information for the 12 months prior to the claim and post disability.

TIPS – To speed up claims assessment and payments, make sure that:

the forms are fully completed and all authorities signed;•full details about other claim payments are provided (pay slips and the letter accepting •liability help to confirm this);

for indemnity plans, the client has provided their financial statements for the two •years before the claim;

for agreed value plans, the client has ready access to their financial information in •case we need it; and

for partial disability payments and where offsets may be applicable, the client has •provided evidence of their pre-disability income.


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Subject Page

Acceptable financial evidence – IP 46

Adding benefits 27

Adviser commission details 58

Alteration requests 27

Alternative offer forum 3

Assessment of claims 97

Australian working overseas 16

Bankruptcy 21

Build/BMI 6

Business loan protection calculation 40

Business decisions 16

Business expense insurance 48

Business expenses covered 48

Business insurance 36

Business Solutions Option

Financial requirements 40

Medical requirements 31

Business Super conversions 18

Calculating personal cover 34

Checklist for application completion 23

Claim payments 104

Claims

Death 97

Income Protection 101

Interim Cover 100

TPD 99

Trauma 100

Claims philosophy 95

Claims requirements 97

Client background 22

Common medical conditions 7

Adviser Easy Reference Guide IndexAdviser Easy Reference Guide to Insurance

Subject Page

Completing applications 23

Contact details 4

Continuation Options 18

Contractors 65

Conversions 17

Depreciation 45

DFAT (Dept of Foreign Affairs and Trade) website

16

Dual occupations 63

Extra morbidity ratings 7

Extra mortality ratings 7

Financial evidence – acceptable for IP

46

Financial requirements – IP claims

103

Financial requirements – Income insurance & Business

expenses (underwriting)

44

Financial requirements – Life 32

Financial underwriting considerations (lump sum)

33

Financial underwriting up-front for IP

46

Further underwriting requirements 26

Health exclusion review 21

Health loading review 21

Helpful underwriting hints 22

Hours worked per week 63

Hypothetical claims queries 96

Income

Employee 45

Self-employed 45

Sole trader 47

108

Subject Page

Own occupation TPD 68

Ownership of income protection 43

Part time employment hours 63

Pathrec 15

Paramedical provider information 15

Partial Disability claim requirements 103

Partnership protection calculation 38

Pastimes 91

Payment of claims 104

Personal insurance calculation 34

Personal loan insurance calculation 35

Philosophy

Claims 95

Underwriting 2

Product information

ADL TPD 53

Business Expenses 57

Income Insurance 54

Life 51

TPD 53

Trauma 52

Pursuits 91

Querying underwriting decisions 16

Questionnaires 26

Reassessment

Health exclusions 21

Health loadings 21

Pursuits loadings or exclusions 21

Reinstatement process 20

Replacement of income ratios 43

Requirements

Death claims 97

Subject Page

Income Protection – general information

43

Income splitting – IP 48

Increase/decrease of sum insured 27

Indemnity IP 46

Insurable income explained – IP 45

Interim cover claims 100

Large case discounts 58

Living overseas 16

Loadings for health 7

Loadings for pursuits 91

Maximum cover amounts 33

Maximum TPD sum insured 33

Maximum Trauma sum insured 34

Medical evidence abbreviations 29

Medical evidence explained 29

Medical examination personal statement

25

Medical requirements

Income Protection/Bus Expenses 44

Life and TPD 30

Trauma 30

New business administration requirements

26

New in business 64

Newly self-employed 64

Non-permanent resident 15

Notification of claims 96

Occupation category review 27

Occupation guide 71

Occupation rating categories explained

67

Overweight 6

Adviser Easy Reference Guide IndexAdviser Easy Reference Guide to Insurance

109

Subject Page

Income protection claims 101

Partial disability 103

Terminal illness claims 98

Total and Permanent disability claims 99

Trauma claims 100

Residency 15

Residing overseas 16

Review of occupation category 21

Seasonal employment 63

Shareholder insurance calculation 38

Smoker to non-smoker process 21

Sub-contractors 65

Sum insured increase/decrease 27

Superannuation contributions 45

Takeover terms 19

Telephone underwriting 25

Temporary residents 15

Terminal illness claims 98

Third party IP ownership 43

TPD maximum sum insured 33

Transfers from other companies 19

Transfers (internal) 17

Trauma claims 100

Travel overseas 16

Underweight 7

Underwriting philosophy 2

Underwriting process 5

Underwriting service charter 2

Underwriting tips 22

Unearned income 47

Unified Healthcare Group (UHG) 15

Waiting period alteration 27

Working from home 65

110


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Important information

This publication has been prepared for distribution to professional financial advisers only and is intended to provide factual information. It is not intended to be distributed or made available to existing or potential product holders. AXA Australia does not authorise the distribution of this publication to, or use by, existing or potential product holders. Existing or potential product holders should base their decision on the detailed information contained in the current Product Disclosure Statement (PDS) and should consult their financial adviser. Applications for purchase of AXA Australia products will only be accepted on receipt of an application form accompanying a current PDS. The National Mutual Life Association of Australasia Limited and its associates derive income from issuing interests in the products, full details of which are contained in the PDSs. This information is provided for persons in Australia only and is not being provided for the use of any person who is in any other country.

0382

4-04

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Australian Casualty & Life Trademark of The National Mutual Life Association

of Australasia Limited ABN 72 004 020 437 AFS Licence No. 234649

GPO Box 5339 Sydney NSW 2001

The National Mutual Life Association of Australasia Limited

ABN 72 004 020 437 AFS Licence No. 234649 Member of the Global AXA Group

Registered Office: 750 Collins Street Docklands Victoria 3008